Pathologic N

This input is used for staging


**Note 1:** Histological examination of a regional lymphadenectomy specimen will ordinarily include 6 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:** Regional lymph nodes for any part of the esophagus fall in the range from periesophageal/cervical to the celiac region. Contralateral and bilateral cervical, supraclavicular, and mediastinal lymph nodes are included. **Note 4:** Celiac nodes are coded in N (regional lymph nodes) for lower thoracic (abdominal) esophagus; they are coded in M (distant metastasis) for cervical and intrathoracic (upper and middle) esophagus. Cervical nodes, NOS are coded in N (regional lymph nodes) for cervical esophagus; they are coded in M (distant metastasis) for upper and lower thoracic (abdominal) esophagus. **Note 5:** Lymph node stations/groups are listed in parentheses when applicable. **Regional Lymph Nodes for Esophagus (including contralateral or bilateral)** **All esophagus subsites** Anterior mediastinal (6) Mediastinal, NOS Peri-/paraesophageal (8L, 8M) **Cervical esophagus (C150)** Anterior deep cervical (laterotracheal) (recurrent laryngeal) Anterior mediastinal (6) Aortopulmonary (5) Cervical, NOS Cervical (deep), NOS Diaphragmatic (15) Internal jugular, NOS Jugulodigastric (subdigastric) Mediastinal, NOS Para-aortic (ascending aorta or phrenic) Paratracheal (2R, 2L, 4R, 4L) Posterior mediastinal (3P) Pulmonary ligament (9) Scalene (inferior deep cervical) (1) Subaortic Supraclavicular (transverse cervical) (1) Superior mediastinal **Upper thoracic esophagus (C151, C153)** Cervical lymph nodes **Lower thoracic (abdominal) esophagus (C152, C155)** Aortopulmonary (5) Diaphragmatic (15) Celiac lymph nodes (20) Left gastric (superior gastric) (17): cardiac (cardial), lesser curvature, perigastric, NOS Para-aortic (ascending aorta or phrenic) Paratracheal (2R, 2L, 4R, 4L) Posterior mediastinal (3P) (tracheoesophageal) Pulmonary ligament (9) Subaortic Superior mediastinal **Intrathoracic esophagus, upper (C153) or middle (C154)** Aortopulmonary (5) Carinal (tracheobronchial) (10R,10L) (tracheal bifurcation) Cervical: deep (NOS), lower (NOS), middle (NOS), upper (NOS) Diaphragmatic (15) Hilar (bronchopulmonary) (proximal lobar) (pulmonary root) Internal jugular, NOS Intrabronchial, NOS Jugulo-omohyoid (supraomohyoid) Jugulodigastric (subdigastric) Left gastric (superior gastric) (17): cardiac (cardial), lesser curvature, perigastric (NOS) Para-aortic (ascending aorta or phrenic) Peritracheal Posterior mediastinal (tracheoesophageal) Pulmonary ligament (9) Superior mediastinal


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 Regional lymph node metastasis Regional lymph nodes, NOS
Lymph nodes, NOS

Stated as N1
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 In situ case but no pTis is defined by TNM
Death certificate only (DCO) case
<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., 69 \# NX is not defined in AJCC 7th edition.