This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'An 80-year-old female who has never taken estrogen, develops pink vaginal discharge. An endometrial biopsy shows an adenocarcinoma of the endometrium. Papanicolaou smear is negative. Of the following what is the most important indicator of prognosis? \nSelect and explain. \nA. Body habitus, B. Level of CA-125, C. Nutritional status, D. Histologic type of tumour', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Prognostic factors in endometrial adenocarcinoma\n\nMost important prognostic factor is lymph node metastasis\nAge at diagnosis (older the patient poorer the prognosis).\nStage of the disease.\nHistologic type (endometriod adenocarcinoma have good prognosis, clear cell carcinoma have poor prognosis).\nHistologic grade .\nMyometrial penetration (Increasing depth of invasion is associated with increasing likelihood of extrauterine spread and recurrence).\nExtension to cervices, Involvement of cervix, isthmus or both is associated with increased risk of extrauterine disease and LN metastasis.\nTumor size (> 2 cm-more lymph node metastasis).\nHormone receptor status (receptor positive-better prognosis).\nPloidy status: Aneuploid have got better prognosis compared to diploid tumors.\nOncogene expression: HER: 2/neu, k-ras poor prognosis.\nRole of Peritoneal cytology on prognosis is controversial.', 'role': 'assistant'}]