EOD Regional Nodes
This input is used for staging
Notes
**Note 1:** For head and neck schemas, this field includes all lymph nodes defined as Levels I-VII and Other by TNM. **Note 2:** This schema has lymph node codes that are defined as **CLINICAL** assessment only or **PATHOLOGICAL** assessment only. + **CLINICAL** assessment only codes (450) are used when there is a clinical work up only and there is no surgical resection of the primary tumor or site. This includes FNA, core biopsy, sentinel node biopsy, or lymph node excision - *Exception:* If patient has neoadjuvant therapy, and the clinical assessment is greater than the pathological assessment, then the clinical assessment code would take priority + **PATHOLOGICAL** assessment only codes (150, 500, 600, 700) are used for Oral Cavity sites when - Primary tumor or site surgically resected with + Any microscopic examination of regional lymph nodes. Includes - FNA, core biopsy, sentinel node biopsy or lymph node excision done during the clinical work up and/or - Lymph node dissection performed - Primary tumor or site NOT surgically resected, but - Lymph node dissection performed + Remaining codes (no designation of **CLINICAL** or **PATHOLOGICAL** only assessment) can be used based on clinical and/or pathological information **Note 3:** If laterality of lymph nodes is not specified, assume nodes are ipsilateral. Midline nodes are ipsilateral. **Note 4:** Supraclavicular lymph nodes can be either Level IV or Level V * Level IV: deep to the sternocleidomastoid muscle, in the lower jugular chain * Level V: in the posterior triangle, inferior to the transverse cervical artery, supraclavicular lymph nodes, NOS **Note 5:** Extranodal extension (ENE) is defined as the extension of a nodal metastasis through the lymph node capsule into adjacent tissue. The following codes record the status of the lymph nodes with positive ENE * Code 150: Pathological only: single ipsilateral node, less than or equal to 3 cm * Code 450: Clinical only: overt ENE * Code 500: Pathological only: single ipsilateral node, greater than 3 cm * Code 600: Pathological only: multiple ipsilateral, bilateral or contralateral nodes * Code 700: Pathological only: Single contralateral node **Note 6:** For codes 100-700, use the list below for named regional lymph nodes. If the only information available is "regional lymph nodes, NOS" or "lymph nodes," code 800. **The following lymph nodes are regional for Head and Neck tumors** **Level I** Level IA - Submental Level IB - Submandibular (submaxillary), sublingual **Level II - Upper jugular** Jugulodigastric (subdigastric) Upper deep cervical Level IIA - Anterior Level IIB - Posterior **Level III - Middle jugular** Middle deep cervical **Level IV - Lower jugular** Jugulo-omohyoid (supraomohyoid) Lower deep cervical Virchow node **Level V - Posterior triangle group** Posterior cervical Level VA - Spinal accessory Level VB - Transverse cervical, supraclavicular **Level VI - Anterior compartment group** Laterotracheal Paralaryngeal Paratracheal - above suprasternal notch Perithyroidal Precricoid (Delphian) Prelaryngeal Pretracheal - above suprasternal notch Recurrent laryngeal **Level VII - Superior mediastinal group (for other mediastinal node(s) see EOD Mets)** Esophageal groove Paratracheal - below suprasternal notch Pretracheal - below suprasternal notch **Other groups** Cervical, NOS Deep cervical, NOS Facial - Buccinator (buccal) - Mandibular - Nasolabial Internal jugular, NOS Parapharyngeal Parotid - Infraauricular - Intraparotid - Periparotid - Preauricular Retroauricular (mastoid) Retropharyngeal Suboccipital **Note 7:** Code 800 if regional lymph nodes are involved, but there is no indication which ones are involved.Default
999NAACCR Item
NAACCR #774| Code | Description | SS2018 N |
|---|---|---|
| 000 | No regional lymph node involvement | NONE |
| 100 | Metastasis in a SINGLE ipsilateral lymph node 3 cm or smaller in greatest dimension Extranodal extension (ENE) negative or unknown | RN |
| 150 | PATHOLOGICAL assessment only Metastasis in SINGLE ipsilateral node 3 cm or smaller in greatest dimension Extranodal extension (ENE) positive | RN |
| 200 | Metastasis in SINGLE ipsilateral node Larger than 3 cm but not larger than 6 cm in greatest dimension Extranodal extension (ENE) negative OR unknown | RN |
| 250 | Metastasis in MULTIPLE ipsilateral nodes No nodes larger than 6 cm in greatest dimension Extranodal extension (ENE) negative or unknown | RN |
| 300 | Metastasis in bilateral or contralateral lymph node(s) No nodes larger than 6 cm in greatest dimension Extranodal extension (ENE) negative OR unknown | RN |
| 400 | Metastasis in a lymph node larger than 6 cm in greatest dimension Extranodal extension (ENE) negative OR unknown | RN |
| 450 | CLINICAL assessment only Metastasis in any lymph node(s) with clinically overt ENE | RN |
| 500 | PATHOLOGICAL assessment only Metastasis in a SINGLE ipsilateral node Larger than 3 cm in greatest dimension Extranodal extension (ENE) positive | RN |
| 600 | PATHOLOGICAL assessment only Metastasis in MULTIPLE ipsilateral, contralateral, or bilateral nodes Extranodal extension (ENE) positive for any node | RN |
| 700 | PATHOLOGICAL assessment only Single contralateral node (any size) Extranodal extension (ENE) positive | RN |
| 800 | Regional lymph node(s), NOS Lymph node(s), NOS | RN |
| 999 | Unknown; regional lymph node(s) not stated Regional lymph node(s) cannot be assessed Not documented in medical record Death Certificate Only | U |