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:** **LAMN tumors**
* Nodal metastasis is very rare in low-grade appendiceal neoplasms (LAMN). If there is no mention of lymph nodes in the pathology report for a LAMN, code as none (000).
**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 (450, 500, 550, 600, 650, 700) when there is a clinical work up only and there is **NO surgical resection of the primary tumor or site**
* Includes imaging or 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, 400) 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 400 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 |
NONE |
| 300 |
**PATHOLOGICAL ASSESSMENT ONLY**
* Cecal
- Anterior (prececal)
- Posterior (retrocecal)
* Colic, NOS
* Epicolic (adjacent to bowel wall)
* Ileocolic
* Mesenteric, NOS
* Mesocolic, NOS
* Paracolic/pericolic
* Right collic |
RN |
| 400 |
**PATHOLOGICAL ASSESSMENT ONLY**
Tumor deposits (TD) in the subserosa, mesentery, mesorectal
or nonperitonealized pericolic or perirectal tissues
WITHOUT regional nodal metastasis |
RN |
| 450 |
**CLINICAL ASSESSMENT ONLY**
One positive node clinically OR Stated as Clinical N1a |
RN |
| 500 |
**CLINICAL ASSESSMENT ONLY**
Two-three positive nodes clinically OR Stated as Clinical N1b |
RN |
| 550 |
**CLINICAL ASSESSMENT ONLY**
Stated as Clinical N1, number of positive nodes clinically unknown |
RN |
| 600 |
**CLINICAL ASSESSMENT ONLY**
Four-six positive nodes clinically OR Stated as Clinical N2a |
RN |
| 650 |
**CLINICAL ASSESSMENT ONLY**
Seven or more positive nodes clinically OR Stated as Clinical N2b |
RN |
| 700 |
**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 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) Overman, M.J., Jessup, J.M., et al. **Appendix - Carcinoma**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
