Which of the following direct lymph node dissections in endometrial carcinoma :

Ans. is a, b and c i.e. Penetration into half of myometrium; Clear cell tumour; and Papillary serous carcinom Indications for lymph node (Pelvic and Para-aoic) dissection in Endometrial cancer (also Indications of poor Prognosis). 1. Tumour histology : Clear cell carcinoma Papillary serous carcinoma Squamous carcinoma Adenocarcinoma (Endometriod) grade II and Ill. More than half of myometrial Invasion Isthmus- cervix extension Tumour size > 2cms Extrauterine disease. As far as Peritoneal metastasis is concerned : "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."