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': 'Which of the following direct lymph node dissections in endometrial carcinoma:a) Penetration into half of myometriumb) Clear cell Carcinomac) Fundal involvement d) Peritoneal metastasise) Papillary serous carcinoma \nSelect and explain. \nA. abc, B. abe, C. cde, D. acd', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Indications for lymph node (pelvic and Para-aortic) dissection in endometrial cancer\nTumor histology:\n\nClear cell carcinoma\nPapillary serous carcinoma\nSquamous carcinoma\n\nAdenocarcinoma (endometriod) grade II and Ill.\nMore than half of myometrial invasion\nIsthmus- cervix extension\nExtrauterine disease\n\nNote: In absence of this factor only bilateral pelvic lymphadenectomy is performed if the tumor size is greater than 2 cms. Para-aortic lymphadenectomy would be performed if pelvic lymph nodes are positive.\nLymphadenectomy is altogether omitted for a patient with above risk factors absent, the absence of cervical involvement and tumor size less than 2 cms.\n\nAs far as Peritoneal metastasis is concerned:\n\n"Positive peritoneal cytology in itself is not a marker of poor prognosis, i.e. is not an indication for lymph node dissection unless and until associated with other poor prognostic markers as above." \xa0 ... Novak 14th /ed p 1358', 'role': 'assistant'}]