Introduction/Background The management of endometrial cancer is undergoing a transformative shift, marked by the 2013 TCGA project revealing four distinct molecular subgroups (POLE, MMR-D, Copy number low, Copy number high) with unique prognostic implications. This molecular insight complements dynamic changes in surgical strategies, particularly in nodal staging, for early-stage endometrial cancer (EC) (stage I/II), now modulated based on identified risk groups. This convergence of molecular advancements and tailored surgical approaches heralds a new era in EC management.

Methodology Conducted at a single centre, this retrospective observational study aims to explore sentinel lymph node (SNL) involvement and risk group stratification based on molecular markers in women with early-stage endometrial cancer. The study enrolled 26 participants who underwent laparoscopic total hysterectomy, bilateral salpingo-oophorectomy, and SNL mapping. Pathologic ultrastaging with immunochemistry and molecular analysis were performed on the pathology specimens.

Results The sample had a mean age of 62 ± 10.09 years and a mean BMI of 29.5 ± 5.45. Bilateral sentinel lymph node detection was successful in 84.6% of cases, with only one specimen exhibiting isolated tumor cells, pN0(i+). MMR-d was identified in 11.5% of specimens, and immunochemistry detected p53 mutation in only one case (3.8%). Focal lymph-vascular space invasion was noted in 15.3% of samples. Regarding FIGO staging, 57.7% were diagnosed as stage IA, 38.5% as stage IB, and 3.8% as stage IIIB. Risk stratification with the integration of molecular markers revealed that 53.9% of the cases were low, 34.7% intermediate, 3.8% intermediate-high, and 7.6% high risk cases.

Conclusion SNL mapping offers diagnostic precision by a minimally invasive approach, thus optimizing patient outcomes while mitigating potential complications. The integration of molecular advancements carries the potential to markedly enhance outcomes and provide tailored care and counselling for individuals with early-stage endometrial cancer.

Disclosures No conflict of interest