EOD Regional Nodes
Notes
**Note 1:** Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in EOD Mets.
**Note 2:** Isolated tumor cells (ITCs) are defined as single tumor cells or small clusters not greater than 0.2 mm, usually detected by immunohistochemical (IHC) or molecular methods. ITCs do not usually show evidence of malignant activity (e.g., proliferation or stromal reaction).
* Lymph nodes with isolated tumor cells (ITCs) are counted as positive lymph nodes
**Note 3:** In-transit, satellite, and/or microsatellite metastasis are metastasis that have occurred via lymphatic or angiolymphatic spread. Satellite nodules are subcutaneous metastasis that occur within 2 cm of the primary tumor. Microsatellite metastasis are microscopic cutaneous metastasis found adjacent or deep to a primary melanoma tumor.
* Code 300 if there are in-transit, satellite, and/or microsatellite metastasis WITHOUT regional lymph node involvement
* Code 500 if there are in-transit, satellite, and/or microsatellite metastasis WITH 1 positive lymph node
* Code 700 if there are in-transit, satellite, and/or microsatellite metastasis WITH 2+ positive lymph nodes
**Note 4:** Bilateral or contralateral nodes are classified as regional nodes for head, neck, and truncal tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. Truncal tumors may also drain to both cephalad and caudal primary nodal basins as shown on lymphoscintigraphy.
* Clinical assessment of bilateral/contralateral or cephalad/caudal regional nodal involvement is required for tumors where lymphoscintigraphy is not performed
**Note 5:** Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins and are coded as regional nodes.
**Note 6:** Regional lymph nodes for skin
* Single, Multiple, Ipsilateral
- See *EOD Mets* for contralateral or bilateral nodes (except for head and neck skin primaries)
**Head and Neck skin primaries only (C000-C002, C006, C440, C442-C444) (includes bilateral or contralateral nodes)**
- Levels I-VII
- Axillary (neck only, C444)
- Cervical, NOS
- Deep cervical, NOS
- Facial (buccinator, buccal, nasolabial)
- Internal jugular, NOS
- Parapharyngeal
- Parotid (infraauricular, intraparotid, periparotid, preauricular)
- Retroauricular (mastoid)
- Retropharyngeal
- Suboccipital
**Skin of trunk (C445)**
- Upper trunk
+ Axillary
+ Cervical
+ Internal mammary
+ Supraclavicular
- Lower trunk
+ Superficial inguinal (femoral)
**Skin of upper limb and shoulder (C446)**
- Axillary
- Cervical
- Epitrochlear for hand/forearm
- Internal mammary (parasternal)
- Spinal accessory for shoulder
- Supraclavicular (transverse cervical)
**Skin of lower limb and hip (C447)**
- Femoral (superficial inguinal)
- Inguinal
- Popliteal for heel and calf
**Vulva (C510-C512, C518-C519)**
- Deep inguinal, NOS
- Femoral
- Inguinal, NOS
- Inguinofemoral (groin)
- Node of Cloquet or Rosenmuller (highest deep inguinal)
- Superficial inguinal (femoral)
**Penis (C600-C602, C608-C609)**
- Iliac, NOS
+ External
+ Internal (hypogastric, obturator)
- Inguinal, NOS
+ Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial [femoral]
- Pelvic, NOS
**Scrotum (C632)**
- Iliac, NOS
+ External
+ Internal (hypogastric), NOS
* Obturator
- Inguinal, NOS
+ Deep inguinal, NOS
* Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial inguinal (femoral)
**Note 7:** See the schema specific anatomical sites for the list of specific regional nodes.
- C210 Anus
- C500 Breast
(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) Gershenwald, J.E., Scolyer, R.A., et al. **Melanoma of the Skin**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017: 563-585