EOD Regional Nodes
Notes
**Note 1:** For head and neck schemes, this field includes all lymph nodes defined as Levels I-VII and Other by TNM.
**Note 2:** If laterality of lymph nodes is not specified, assume nodes are ipsilateral. Midline nodes are considered ipsilateral.
**Note 3:** For head and neck cancers, if lymph nodes are described only as "supraclavicular", try to determine if they are in Level IV (deep to the sternocleidomastoid muscle, in the lower jugular chain) or Level V (in the posterior triangle, inferior to the transverse cervical artery) and code appropriately. If the specific level cannot be determined, consider them as Level V nodes.
**Note 4:** For nasopharynx, Levels I, II, III, V, VI, are assigned code 300 or 400 based on size and/or unilateral vs bilateral. For Levels IV, VB, and VII, see code 600. 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
| Code |
Description |
SS2018 N |
| 000 |
No regional lymph node involvement |
NONE |
| 300 |
Cervical lymph node(s), unilateral, 6 cm or smaller
Retropharyngeal lymph node(s), unilateral or bilateral, 6 cm or smaller
above the caudal border of cricoid cartilage |
RN |
| 400 |
Cervical lymph node(s), bilateral, 6 cm or smaller
above the caudal border of cricoid cartilage |
RN |
| 600 |
Cervical lymph node(s), unilateral or bilateral, greater than 6 cm
AND/OR extension below the caudal border of cricoid cartilage |
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 patient record
Death Certificate Only |
U |
(1) Fritz AG, Ries LAG (eds). **SEER Extent of Disease 1988: Codes and Coding Instructions (3rd Edition, 1998)**, National Cancer Institute, NIH Pub. No. 98-2313, Bethesda, MD, 1998
(2) Young JL Jr, Roffers SD, Ries LAG, Fritz AG, Hurlbut AA (eds.). **SEER Summary Staging Manual-2000: Codes and Coding Instructions**, National Cancer Institute, NIH Pub. No. 01-4969, Bethesda, MD, 2001.
(3) Collaborative Stage Work Group of the American Joint Committee on Cancer. **Collaborative Stage Data Collection System User Documentation and Coding Instructions, version 02.05**. American Joint Committee on Cancer (Chicago, IL)
(4) Gress, D.M., Edge, S.B., Gershenwald, J.E., et al. **Principles of Cancer Staging**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 3-30
(5) Lydiatt, W.M., Patel, S.G., Shah, J.P., et al. **Staging Head and Neck Cancers**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 55-65
(6) Lee, A.W.M., Lydiatt, W.M., Shah, J.P., et al. **Nasopharynx**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 103-111
