This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Carcinoma Endometrium, Subject name: Gynaecology & Obstetrics
[{'content': 'Endometrial Ca with poor prognosis: \nSelect and explain. \nA. Adeno grade 2, B. Adenosquamous, C. Adenoacanthoma, D. Clear cell', 'role': 'user'}, {'content': "Answer: D \nExplanation: Ref: Novak's Gynecology. 14'h ed. Pg 1359. Explanation:The following cases have poor prognosis in endometrial cancer and require pelvic and paraaortic lymph node dissection during surgery.Tumor histology clear cell, serous, squamous, or grade 2-3 endometrioidMyometrial invasion >ViIsthmus-cervix extensionTumor size >2 cmExtrauterine disease", 'role': 'assistant'}]