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:** **Unnamed nodes**
* **For Colon and Rectum ONLY**, any unnamed nodes that are removed with a colon or rectal resection are presumed to be regional pericolic or perirectal lymph nodes and are included in the EOD Regional Nodes code 300 (pericolic for sites C180 - C189, C199 and perirectal for sites C199 or C209).
* This site-specific instruction applies only to colon and rectum tumors and was verified with subject matter experts.
**Note 3:** **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 (350, 400, 450, 500, 550, 600) 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/.
**Note 4:** **Tumor Deposits**
* Code 200 is defined as **PATHOLOGICAL** assessment only. This is used when
* Primary tumor or site surgically resected with
* Any positive microscopic examination of tumor deposits WITHOUT positive lymph nodes
* If there are also positive lymph nodes, code 300
| Code |
Description |
SS2018 N |
| 000 |
No regional lymph node involvement and no tumor deposits (TD) |
NONE |
| 200 |
**PATHOLOGICAL ASSESSMENT ONLY**
Tumor deposits (TD) in the subserosa, mesentery, mesorectal
or nonperitonealized pericolic or perirectal tissues
**WITHOUT** regional nodal metastasis |
RN |
| 300 |
**PATHOLOGICAL ASSESSMENT ONLY**
All sites (C180, C182-C189)
- Colic, NOS
- Epicolic (adjacent to bowel wall)
- Mesenteric, NOS
- Mesocolic, NOS
- Paracolic
- Pericolic
Cecum (C180)
- Cecal, NOS
+ Anterior cecal (prececal)
+ Posterior cecal (retrocecal)
- Colic (right)
- Ileocolic
- Periappendiceal
Ascending colon (C182)
- Colic (middle-right branch, right)
- Ileocolic
Hepatic flexure (C183)
- Colic (middle, right)
- Ileocolic
Transverse colon (C184)
- Colic (middle)
Splenic flexure (C185)
- Colic (left, middle)
- Mesenteric (inferior)
Descending colon (C186)
- Colic (left)
- Mesenteric (inferior)
- Sigmoid
Sigmoid colon (C187)
- Colic (left)
- Mesenteric (inferior)
- Rectal (superior) (hemorrhoidal)
- Rectosigmoid
- Sigmoid (sigmoidal) (sigmoid mesenteric)
- Superior rectal (hemorrhoidal)
Rectosigmoid (C199)
- Hemorrhoidal (middle, superior)
- Mesenteric (inferior)
- Mesorectal
- Pericolic
- Perirectal
- Rectal (middle, superior)
- Sigmoid (mesenteric)
Rectum (C209)
- Hemorrhoidal (middle, superior)
- Iliac (hypogastric, internal, obturator) (see EOD Mets for common, external, NOS)
- Mesenteric (inferior)
- Mesorectal
- Perirectal
- Rectal (inferior)
- Sacral, NOS
+ Lateral sacral (laterosacral)
+ Middle sacral (promontorial) (Gerota's node)
+ Presacral
- Sigmoidal (sigmoid mesenteric) |
RN |
| 350 |
**CLINICAL ASSESSMENT ONLY**
One positive node clinically OR Stated as Clinical N1a |
RN |
| 400 |
**CLINICAL ASSESSMENT ONLY**
Two-three positive nodes clinically OR Stated as Clinical N1b |
RN |
| 450 |
**CLINICAL ASSESSMENT ONLY**
Stated as Clinical N1, number of positive nodes clinically unknown |
RN |
| 500 |
**CLINICAL ASSESSMENT ONLY**
Four-six positive nodes clinically OR Stated as Clinical N2a |
RN |
| 550 |
**CLINICAL ASSESSMENT ONLY**
Seven or more positive nodes clinically OR Stated as Clinical N2b |
RN |
| 600 |
**CLINICAL ASSESSMENT ONLY**
Stated as Clinical N2, number of positive nodes clinically unknown |
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 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) Jessup, J.M., Goldberg, R.M., et al. **Colon and Rectum**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
