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: Surgery
[{'content': 'What is the best prognostic marker of CA penis: \nSelect and explain. \nA. age <40 yrs, B. lesion size < 2 cm, C. previous circumcision, D. absent inguinal LN metastasis', 'role': 'user'}, {'content': 'Answer: D \nExplanation: The most important prognostic and treatment-related factor in penile ca is the presence and degree of nodal disease. Smith\'s Urology writes — "Survival in penile carcinoma correlates with the presence or absence of nodal disease.\nFive-year survival rates for patients with node-negative disease range from 65% to 90%. For patients with positive inguinal nodes, this rate decreases to 30-50% and with positive iliac nodes decreases to less than 20%. In the presence of soft-tissue or bony metastases, no 5-year survivors have been reported."', 'role': 'assistant'}]