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 metastasis is defined as a tumor distinct from the primary lesion and located either between the primary lesion and the draining regional lymph node(s) or distal to the primary lesion. In transit metastasis with positive lymph node(s) are coded under regional lymph nodes. * Code 600 if there are **clinically** in-transit metastasis WITHOUT regional lymph node involvement * Code 650 if there are **clinically** in-transit metastasis WITH regional lymph node involvement * Code 700 if there are **pathologically** in-transit metastasis WITHOUT regional lymph node involvement * Code 750 if there are **pathologically** in-transit metastasis WITH regional lymph node involvement **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)
Code Description SS2018 N
000 No regional lymph node metastasis detected on clinical AND/OR radiologic examination, (sentinel node) biopsy or lymph node dissection NONE
100 CLINICAL ONLY Clinical and/or radiologic exam positive nodes - WITHOUT biopsy or resection of lymph nodes RN
200 CLINICAL ONLY Clinically positive nodes on core biopsy/FNA - WITHOUT sentinel lymph node biopsy or resection of lymph nodes RN
300 PATHOLOGICAL ONLY Clinically occult nodes - WITH positive nodes from sentinel node biopsy RN
350 PATHOLOGICAL ONLY Clinically occult nodes - WITH positive nodes on lymph node resection RN
400 PATHOLOGICAL ONLY Clinically and/or radiologically positive nodes - WITH positive nodes on biopsy or lymph node resection RN
500 PATHOLOGICAL ONLY Clinically unknown if positive or negative - WITH positive nodes on biopsy or lymph node resection RN
600 CLINICAL ONLY In-transit metastasis present - WITHOUT lymph node metastasis or UNKNOWN Discontinuous from primary tumor Located between primary tumor and draining regional nodal basin OR distal to the primary tumor RN
650 CLINICAL ONLY Code 600 WITH lymph node metastasis RN
700 PATHOLOGICAL ONLY In-transit metastasis present - WITHOUT lymph node metastasis or UNKNOWN Discontinuous from primary tumor Located between primary tumor and draining regional nodal basin OR distal to the primary tumor RN
750 PATHOLOGICAL ONLY Code 700 WITH lymph node metastasis 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
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