The Evolution of Sentinel Node Biopsy in Urological Malignancy

Sentinel lymph node biopsy (SLNB) provides an accurate staging tool for a variety of malignancies including urological cancers. Initially introduced as a single procedure technique, SLNB has evolved into a dynamic multistage procedure that has an invaluable impact on the management of cancer patients. After a thorough literature search, this article summarizes the advancement of the SLNB procedure since its conception. The introduction of radioactive tracers and blue dye has resulted in a highly sensitive technique but one around which concerns persist. This paper updates existing material on the topic by examining the potential of near infra-red fluorescence optical imaging agents (NIRF) and anatomical fusion imaging as useful adjuncts to the currently practiced technique. SLNB has an established role in penile cancer with a well-documented improvement in morbidity and mortality rates. The presence of sentinel nodes in pelvic malignancy is controversial but papers have established that the technique is feasible for use in such cancers and that NIRF may have a role to play here in the future. SLNB currently has no place in the management of testicular or renal malignancy.