Pathologic N

This input is used in derivation

Notes

**Note 1:** Histological examination of a regional lymphadenectomy specimen will ordinarily include 16 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0. (1) **Note 2:** Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in M (distant metastasis). **Note 3:** Assign N1 if regional lymph nodes are involved but there is no indication of the number of nodes involved. **Note 4:** Assign as regional node metastases when there are metastatic nodules in the fat adjacent to a gastric carcinoma WITHOUT evidence of residual lymph node tissue; assign as M (distant metastases) for nodules implanted on peritoneal surfaces. **Regional lymph nodes for Stomach are:** Celiac: Hepatic Hepatoduodenal (for lesser curvature) Left gastric (superior gastric), NOS: Cardial Cardioesophageal Gastric, left Gastropancreatic, left Lesser curvature Lesser omental Paracardial Nodule(s) in perigastric fat Pancreaticosplenic (pancreaticolienal) Pancreaticoduodenal Perigastric, NOS Peripancreatic Right gastric (inferior gastric), NOS: Gastrocolic Gastroduodenal Gastroepiploic (gastro-omental), right or NOS Gastrohepatic Greater curvature Greater omental Pyloric, NOS: infrapyloric, subpyloric, suprapyloric Splenic (lienal), NOS: Gastroepiploic (gastro-omental), left Splenic hilar Regional lymph nodes, NOS Lymph nodes, NOS

NAACCR Item

NAACCR #890
Pathologic N Pathologic N Display Description Registrar Notes
pX pNX Regional lymph nodes cannot be assessed Pathologic classification criteria met, evaluation done:
Physician unable to assess N
Surgical resection primary tumor, no regional lymph nodes removed
Involvement of regional lymph nodes not documented
Physician assigns pNX, no other information available to determine N
p0 pN0 No regional lymph node metastasis
p1 pN1 Metastasis in 1-2 regional lymph nodes Regional lymph nodes, NOS
Lymph nodes, NOS

Stated as N1
p2 pN2 Metastasis in 3-6 regional lymph nodes Stated as N2
p3 pN3 Metastasis in 7 or more regional lymph nodes Note: N3 has subcategories of N3a and N3b. Assign N3 only when there is no information available to assign one of the subcategories

Stated as N3 [NOS]
p3A pN3a Metastasis in 7-15 regional lymph nodes Stated as N3a
p3B pN3b Metastasis in 16 or more regional lymph nodes Stated as N3b
c0 cN0 Clinically: No regional lymph node metastasis Use only for TNM defined pTis cases where there is a resection of the primary and the nodes are not evaluated pathologically
88 88 Not applicable Primary site/histology not TNM defined
<BLANK> BLANK See Registrar Notes Pathologic classification criteria not met
No surgical resection of primary tumor and there isn’t a positive biopsy of a structure in the highest T category and highest N category
Evidence of metastatic disease (pM1), no other workup
Only Pathologic Stage Group documented (no T, N, or M information available)
(1) International Union Against Cancer (UICC) *TNM Classification of Malignant Tumors,* 7th ed., Sobin, LH, Gospodarowicz, M, Wittekind, CH, eds. New York: Wiley, 2009, pg., 76