EOD Regional Nodes
Notes
**Note 1:** **Regional nodes and nodes, NOS**
* Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in EOD Mets.
**Note 2:** **Hepatoduodenal and Pancreaticoduodenal lymph nodes**
* Per AJCC, Hepatoduodenal nodes are regional for **all subsites** of the stomach. Previously they were regional only for the lesser curvature and the greater curvature.
**Note 3:** **Metastatic nodules in the fat**
* Metastatic nodules in the fat adjacent to a gastric carcinoma, without evidence of residual lymph node tissue, are classified as regional node metastases, but nodules implanted on peritoneal surfaces are classified as distant metastases (see EOD Mets).
**Note 4:** **CLINICAL AND PATHOLOGICAL codes**
* This schema has lymph node codes that are defined as **CLINICAL** assessment only or **PATHOLOGICAL** assessment only.
**No surgical resection**
* Use **CLINICAL** assessment only codes (400, 450, 500, 600, 700) when there is a clinical work up only and there is **NO surgical resection of the primary tumor or site** WITH
* Any microscopic examination of regional lymph nodes, which includes FNA, core biopsy, sentinel node biopsy, lymph node excision, or lymph node dissection done during the clinical work up.
**Surgical resection without neoadjuvant therapy**
* Use **PATHOLOGICAL** assessment only codes (300) when there is a **surgical resection of the primary tumor or site** WITH
* Any microscopic examination of regional lymph nodes, which includes FNA, core biopsy, sentinel node biopsy, lymph node excision done or lymph node dissection performed.
**Surgical resection after neoadjuvant therapy**
* If patient has neoadjuvant therapy, and the clinical assessment is equal to or greater than the pathological assessment, then the clinical assessment codes take priority. Otherwise, code the pathologic assessment.
* See ***EOD 2018 General Instructions*** for further instructions on coding cases with neoadjuvant therapy, https://seer.cancer.gov/tools/staging/eod/.
| Code |
Description |
SS2018 N |
| 000 |
No regional lymph node involvement |
NONE |
| 300 |
**PATHOLOGICAL ASSESSMENT ONLY**
Celiac artery
Common hepatic artery
Hepatic, NOS
Left gastric (superior gastric), NOS
- Cardial, NOS
- Cardioesophageal
- Gastric artery
- Gastric, left
- Gastrohepatic
- Gastropancreatic, left
- Lesser curvature
- Lesser omentum
- Paracardial
Pancreaticosplenic (pancreaticolineal)
Perigastric, NOS
Peripancreatic
Pyloric, NOS
- Infrapyloric (subpyloric)
- Suprapyloric
Right gastric (inferior gastric, NOS)
- Gastrocolic
- Gastroduodenal
- Gastroepiploic (gastro-omental), right or NOS
- Gastrohepatic
- Greater curvature
- Greater omentum
- Pancreaticoduodenal
Splenic (lineal), NOS
- Gastroepiploic (gastro-omental), left
- Splenic hilar/hilum
Nodule(s) in perigastric fat |
RN |
| 400 |
**PATHOLOGICAL ASSESSMENT ONLY**
Hepatoduodenal and Pancreaticoduodenal lymph nodes (See Note 2)
* All subsites of stomach |
D |
| 450 |
**CLINICAL ASSESSMENT ONLY**
One-two positive nodes clinically OR stated as Clinical N1 |
RN |
| 500 |
**CLINICAL ASSESSMENT ONLY**
Three-six positive nodes clinically OR stated as Clinical N2 |
RN |
| 600 |
**CLINICAL ASSESSMENT ONLY**
Seven to fifteen nodes clinically OR stated as Clinical N3 [NOS] OR N3a |
RN |
| 700 |
**CLINICAL ASSESSMENT ONLY**
Fifteen nodes or greater clinically OR stated as Clinical N3b |
RN |
| 800 |
Positive nodes, number unknown
Unknown if clinical or pathological assessment
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 |
(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) Ajani, J.A., In, H., Sano, T., Hofstetter, W.L., et al. **Stomach**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
