EOD Regional Nodes
**Note 1:** Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in EOD Mets.
**Note 2:** Codes 100-750 are based on the following criteria
+ How the nodes were determined
* Clinically occult (not clinically apparent) and found to be positive on microscopic examination (e.g., on sentinel lymph node procedure)
* Clinically detected (clinically apparent) WITH or WITHOUT microscopic confirmation
+ Number of nodes involved
+ Presence of in-transit, satellite or microsatellite mets (see Note 4)
**Note 3:** 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 4:** 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 or more positive lymph nodes
**Note 5:** 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 6:** Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins and are coded as regional nodes.
**Note 7:** Regional lymph nodes for skin
* Single, Multiple, Ipsilateral, Bilateral or Contralateral lymph nodes
**Skin of head and neck (C000-C002, C006, C440-C444)**
- Levels I-VII
- Axillary (neck only, C444)
- Cervical, NOS
- Deep cervical, NOS
- Facial (buccinator, buccal, nasolabial)
- Internal jugular, NOS
- Parotid (infraauricular, intraparotid, periparotid, preauricular)
- Retroauricular (mastoid)
**Skin of upper limb and shoulder (C446)**
- Epitrochlear for hand/forearm
- Internal mammary (parasternal)
- Spinal accessory for shoulder
- Supraclavicular (transverse cervical)
**Skin of lower limb and hip (C447)**
- Femoral (superficial inguinal)
- Popliteal for heel and calf
**Vulva (C510-C512, C518-C519)**
- Deep inguinal, NOS
- Inguinal, NOS
- Inguinofemoral (groin)
- Node of Cloquet or Rosenmuller (highest deep inguinal)
- Superficial inguinal (femoral)
**Penis (C600-C602, C608-C609)**
- Iliac, NOS
+ Internal (hypogastric, obturator)
- Inguinal, NOS
+ Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial [femoral]
- Pelvic, NOS
- Iliac, NOS
+ Internal (hypogastric), NOS
- Inguinal, NOS
+ Deep inguinal, NOS
* Node of Cloquet or Rosenmuller (highest deep inguinal)
+ Superficial inguinal (femoral)
**Note 8:** See the schema specific anatomical sites for the list of specific regional nodes.
- C210 Anus
- C500 Breast
**Note 9:** Code 800 if regional lymph nodes are involved, but there is no indication which ones are involved.
(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
(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