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: Pathology
The worst prognosis for renal cell carcinoma is 
Select and explain. 
A. Vascular invasion, B. Associated with hypercalcemia, C. Presence of Hematuria, D. Size more than 5 cm.
A: Vascular invasion
Answer: A: Vascular invasion 
Explanation: None