<prompt> 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 carcinomaabcabecdeacd  <response>: Indications for lymph node pelvic and Para-aortic dissection in endometrial cancerTumor histology:Clear cell carcinomaPapillary serous carcinomaSquamous carcinomaAdenocarcinoma endometriod grade II and Ill.More than half of myometrial invasionIsthmus- cervix extensionExtrauterine diseaseNote: 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.Lymphadenectomy is altogether omitted for a patient with above risk factors absent, the absence of cervical involvement and tumor size less than 2 cms.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. ... Novak 14th ed p 1358 