Background/Objectives: Nowadays, lymph node assessment represents a key component in the surgical staging of endometrial cancer, as sentinel lymph node (SLN) mapping increased in adoption as an alternative to lymphadenectomy. This study aimed to compare SLN mapping and selective lymph node sampling (SLNS) in endometrial cancer cases managed in a tertiary oncologic center. Moreover, the study evaluated clinicopathological characteristics and the association between tumor stage and nodal involvement. Methods: This prospective observational cohort study included 137 patients with histologically confirmed endometrial cancer who underwent surgical staging between January 2020 and August 2025. Either SLN mapping using indocyanine green (ICG) or methylene blue (blue dye–BD) or SLNS was performed during the surgery. Clinical, surgical, and histopathological data were analyzed using descriptive and inferential statistics. Results: SLN mapping was performed in 86 patients (BD: 45; ICG: 41), while the other 51 underwent SLNS. Median lymph node yield was significantly higher in the SLNS group (10 nodes) in comparison to SLN mapping (four nodes for both BD and ICG; p < 0.001). The overall nodal metastasis rate was 9.5%, with no significant difference between techniques (SLNS: 9.8%, BD: 8.9%, ICG: 9.8%; p = 0.99). Bilateral nodal detection rates were higher in the BD group compared to the ICG group (73.3% vs. 51.2%; OR = 2.62, p = 0.045). Nodal involvement increased significantly in parallel with advancing pathological T stage (p < 0.001), ranging from 0% in T1a to 40.0% in T3a disease. Conclusions: Even though SLNS resulted in a higher number of lymph nodes retrieved, SLN mapping demonstrated similar observed rates of nodal metastases across groups within the limits of this observational study. BD demonstrates superior bilateral detection rates compared to ICG in this cohort. Tumor stage remains a predictor of lymph node involvement. All these findings justify the use of SLN mapping as an effective staging strategy in patients with endometrial cancer.

Background/Objectives: In patients with clinically node-positive breast cancer, axillary response to neoadjuvant systemic treatment is heterogeneous and might depend on tumor biology. In patients with cN2 disease, the identification of factors linked to nodal response could improve risk stratification and contribute to the development of individualized post-neoadjuvant axillary management strategies. Methods: This cohort study has a retrospective design and included 560 female patients with invasive breast cancer (proven via biopsy) and cN2 disease. All patients received neoadjuvant systemic treatment accompanied by breast and axillary surgery at the Institute of Oncology “Prof. Dr. Ion Chiricuță” Cluj-Napoca (IOCN), Romania, between 2017 and 2025. The primary endpoint was the rate of axillary pathological complete response (pCR) following neoadjuvant systemic therapy, defined as ypN0. Secondary endpoints included breast pCR (ypT0), overall pCR (ypT0N0), the association between breast and axillary pathological response and survival analysis, including overall survival (OS) and disease-free survival (DFS). Clinicopathological predictors were assessed using univariate and multivariate logistic regression, while survival outcomes were evaluated with time-to-event analyses. Results: Complete axillary pathological response occurred in 282/560 patients (50.4%), and it increased to 53.2% when ypN0, including ypN0(i+). Breast pathological complete response was achieved in 31.2%, while overall pCR was 27.0%. Axillary response was significantly different in terms of molecular subtype, as ypN0 rates were 26.6% in Luminal A-like, 32.5% in Luminal B-like, 78.9% in HER2-positive and 72.6% in TNBC (p < 0.001). Nottingham grade 3 and HER2-positive disease were independently related to increased odds of ypN0, while TILs <10% were associated with lower odds of complete axillary response when multivariate analysis was performed. Breast and axillary responses were significantly associated (but were not interchangeable), as ypT0 showed 53.5% sensitivity and 91.9% specificity for ypN0. Overall pCR was associated with improved DFS (p = 0.040), while ypN0 and ypT0 were not significantly associated with DFS. No significant OS differences were noticed regarding pathological response. Conclusions: Nearly half of patients with cN2 breast cancer presented a complete axillary response after the completion of neoadjuvant treatment. Molecular subtype, histological grade and TILs were strongly associated with axillary response. In our cohort, breast pathological response alone was insufficient in order to be regarded as a predictor of nodal clearance, further supporting independent assessments of breast and axillary response. Further prospective studies are needed to determine whether these findings can inform individualized axillary management after neoadjuvant treatment.

In patients with advanced or metastatic melanoma, BRAF mutation assessment is routinely performed to identify patients who may benefit from BRAF-targeted therapy. This study aimed to assess the role of BRAF mutation status in relation to histopathological characteristics and survival of patients with stage II and III malignant melanoma. A prospective cohort of 108 patients with pT3 malignant melanoma who were treated in a comprehensive cancer center were included in the analysis. All patients were treated according to contemporary melanoma management guidelines between 2016 and 2024, with a minimum follow-up of 12 months extending to 2025. Overall survival (OS) and progression-free survival (PFS) analyses were performed in the study cohort. The study included 108 patients with stage II–III malignant melanoma, with a mean age of 56.73 ± 13.51 years. Superficial spreading melanoma was the most frequent histological subtype, followed by nodular and acral melanoma. Most tumors were classified as Clark level IV, with a median Breslow thickness of 3 mm, and ulceration was present in the majority of cases. Lymph node involvement was observed in over half of the patients, and BRAF mutations were identified in 56.48% of cases (the most common variant was V600E). Brisk tumor-infiltrating lymphocytes were significantly more frequent in BRAF wild-type tumors compared with BRAF-mutant tumors. When assessing associations with survival, BRAF mutation status was not found to be an independent predictor. In the multivariate Cox model, TIL status was associated with improved OS (HR 3.33, 95% CI 1.41–7.88, p = 0.006). In addition, in the multivariate analysis, TIL status was also associated with improved PFS (HR 5.23, 95% CI 2.22–12.3, p < 0.001). BRAF wild-type tumors were significantly more likely to exhibit a brisk infiltrate. BRAF mutation status was not found to be an independent predictor of survival. TIL status remained significantly associated with OS and PFS in multivariable analysis.