O Papel Atual da Biópsia do Linfonodo Sentinela na Oncologia Cirúrgica Pediátrica: Foco em Melanoma e Sarcoma

Abstract

Introduction: In recent years, although sentinel lymph node biopsy (SLNB) is well established in adult oncology, its application in the pediatric population still raises questions, mainly due to the rarity and uniqueness of pediatric melanoma and sarcomas. Moreover, the introduction of indocyanine green (ICG) has shown promising operative advantages, allowing greater precision and less interference, without significant adverse events. Therefore, although SLNB proves technically feasible and clinically relevant for children, there is a pressing need for more robust prospective studies to consolidate adapted protocols, minimizing risks and improving lymph node staging in this unique age group.Objectives: To evaluate the safety, efficacy, and applicability of sentinel lymph node biopsy using indocyanine green in pediatric oncology. Methodology: This narrative review analyzed studies from 2000 to 2024 on sentinel lymph node biopsy in pediatric oncology, focusing on melanoma and sarcomas, addressing safety, efficacy, techniques, and clinical outcomes, excluding adult studies and case reports.Results and Discussion: The use of indocyanine green combined with technetium-99m is safe and effective for identifying sentinel lymph nodes in children with melanoma and sarcoma, providing better visualization and less surgical interference. However, the low incidence and heterogeneity of pediatric cases limit the standardization of the technique, requiring multicenter studies to confirm its efficacy and long-term benefits.Conclusion: The combination of indocyanine green with technetium-99m proves safe and effective for identifying sentinel lymph nodes in children but requires larger prospective studies. Multicenter initiatives are essential to standardize the technique and improve the management of pediatric melanoma and sarcoma.