Background/Objective: Sentinel lymph node (SLN) mapping is an accepted technique for the nodal staging of early-stage endometrial cancer. It is carried out commonly by minimally invasive approach, either by laparoscopy or robotics-assisted surgery. The primary aim of this study was to compare the detection rate of SLN mapping between laparoscopic and robotic surgery. Methods: A retrospective observational study including patients operated on from February 2024 to March 2025, diagnosed with endometrial cancer who underwent hysterectomy, bilateral salpingo-oophorectomy and SLN mapping. Among a total of 60 patients, 38 (63.3%) underwent laparoscopic surgery and 22 (36.7%) robotic surgery. We compared SLN detection rate and perioperative outcomes between the two routes of approach. Results: No significant differences were observed in the overall and bilateral SLN detection rate between laparoscopic and robotic surgery (97.3% and 84.2% vs. 95.5% and 91%, respectively). Significant differences were observed in operative time, with a median of 125 vs. 110 min (p = 0.004), and in hospital stay, with a median of 3 vs. 2 days (p = 0.002), with both being shorter in the robotic surgery group. No differences were observed in terms of number of SLN detected, percentage of positive nodes, intra or postoperative complications rate, or percentage of conversion to laparotomy. Conclusions: No differences were found in SLN detection rates between laparoscopic and robotic surgery. However, robotic surgery demonstrated advantages in terms of reduced operative time and shorter hospital stay.

Background: Molecular classification has transformed risk stratification in endometrial cancer, providing prognostic information beyond traditional clinicopathologic features. However, the relationship between molecular subtype, nodal involvement, and recurrence risk remains incompletely defined. This study aimed to compare lymph node metastasis rates across molecular subgroups and evaluate survival outcomes and prognostic factors for recurrence. Methods: We conducted a retrospective study including 158 patients with a preoperative diagnosis of presumed early-stage endometrial carcinoma treated surgically between 2021 and 2024. Molecular classification was performed according to WHO criteria, including POLE-ultramutated, mismatch repair deficient (MMRd), p53-abnormal (p53-abn), and no specific molecular profile (NSMP). Sentinel lymph node biopsy (SLNB) was the primary method for nodal staging. Survival outcomes were assessed using a Kaplan–Meier analysis, and logistic regression was used to identify prognostic factors for recurrence. Results: NSMP was the most frequent molecular subtype (44.3%), followed by MMRd (29.1%), p53-abn (20.9%), and POLE-mutated tumors (5.7%). Overall, 11.4% of patients had nodal metastases, most commonly in the p53-abn subgroup, which showed significantly higher rates of positive sentinel lymph nodes (p = 0.010). Prognosis differed significantly across molecular subtypes. POLE-mutated and NSMP tumors demonstrated the most favorable outcomes, while p53-abn tumors showed the poorest overall survival and progression-free survival. In a univariate analysis, grade, lymphovascular space invasion (LVSI), myometrial invasion, FIGO stage, and molecular classification were associated with recurrence. Stratified analyses suggested LVSI as the most relevant prognostic factor within the MMRd subgroup. Conclusions: Molecular classification is strongly associated with nodal involvement and survival outcomes in early-stage endometrial cancer. Integrating molecular subtype with clinicopathologic factors may improve recurrence risk stratification and guide individualized surgical and adjuvant treatment strategies.