Background/Objectives: Achieving complete, yet safe tumor resections are particularly challenging in pediatric oncology due to infiltrative tumor growth patterns, small patient size, and the close proximity to critical structures. Fluorescence-guided surgery (FGS) enhances visualization of anatomy, tissue perfusion, and tumor tissue in real time, potentially improving surgical precision. While widely explored in adults, its application in pediatric oncology remains limited. This review summarizes current evidence on FGS in pediatric oncology, with emphasis on the unique challenges inherent to this field. Finally, strategies to accelerate clinical translation and assess the potential clinical value are proposed.Methods: A narrative review of the literature was conducted using PubMed and Embase to identify English-language publications on FGS in pediatric oncology up to September 2025. Search terms included Fluorescence, Pediatrics, Neoplasms, and Surgery.Results: Studies commonly reported that indocyanine green (ICG) aids in lymph node mapping, hepatoblastoma resection, and visualization of vascular structures and tissue perfusion. However, its non-specific nature and lack of histopathological validation limits diagnostic precision in tumor imaging. Tissue-specific agents are being investigated in first-in-humans trials to improve sensitivity and specificity, and to identify ureters and nerves.Conclusions: In this review, the challenging roadmap for advancing FGS in pediatric oncology is presented. Closing current gaps will require coordinated efforts in target discovery, agent design, and clinical validation. If successful, FGS can evolve from a promising tool into an indispensable clinical technique that enhances surgical precision, reduces recurrence, and ultimately improves long-term outcomes for children with cancer.
**背景/目的：** 在儿童肿瘤学中，由于肿瘤呈浸润性生长模式、患儿体型小以及肿瘤毗邻关键结构，实现完全且安全的肿瘤切除尤其具有挑战性。荧光引导手术（FGS）能够实时增强对解剖结构、组织灌注和肿瘤组织的可视化，从而可能提高手术精准度。尽管FGS在成人中已得到广泛探索，但其在儿童肿瘤学中的应用仍然有限。本综述总结了当前关于FGS在儿童肿瘤学中的证据，重点强调了该领域固有的独特挑战。最后，提出了加速临床转化和评估其潜在临床价值的策略。 **方法：** 使用PubMed和Embase数据库对截至2025年9月关于儿童肿瘤学FGS的英文文献进行了叙述性综述。检索词包括荧光、儿科、肿瘤和手术。 **结果：** 研究普遍报道，吲哚菁绿（ICG）有助于淋巴结定位、肝母细胞瘤切除以及血管结构和组织灌注的可视化。然而，其非特异性性质以及缺乏组织病理学验证，限制了其在肿瘤成像中的诊断精确性。目前正在人体首次试验中研究组织特异性示踪剂，以提高敏感性和特异性，并用于识别输尿管和神经。 **结论：** 本综述阐述了在儿童肿瘤学中推进FGS应用所面临的挑战性路线图。要弥补当前的差距，需要在靶点发现、示踪剂设计和临床验证方面进行协调一致的努力。如果成功，FGS可以从一种有前景的工具，发展成为一种不可或缺的临床技术，从而提高手术精准度、减少复发，并最终改善癌症患儿的长期预后。
Fluorescence-Guided Surgery in Pediatric Oncology: Current Practice and Future Directions
肿瘤(癌症)患者之家