Clinical N

This input is used for staging

Notes

**Note 1:** Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in M (distant metastasis). **Note 2:** If at mediastinoscopy/x-ray, the description is "mass", "adenopathy", or "enlargement" of any of the lymph nodes named as regional lymph nodes in N1 or N2, assume that at least regional lymph nodes are involved. * If there is any mention of bilateral or contralateral mass, adenopathy or lymph node involvement, assign N3 **Note 3:** The words "no evidence of spread" or "remaining examination negative" are sufficient information to classify regional lymph nodes as negative in the absence of any statement about nodes. **Note 4:** Vocal cord paralysis (resulting from involvement of the recurrent branch of the vagus nerve), superior vena cava (SVC) obstruction, or compression of the trachea or the esophagus, may be related to direct extension of the primary tumor or to lymph node involvement. The treatment options and prognosis associated with these manifestations of disease extent fall within the T4-Stage IIIB category; therefore, generally assign T4 for these manifestations and not regional lymph nodes. * If the primary tumor is peripheral and clearly unrelated to vocal cord paralysis, SVC obstruction, or compression of the trachea or the esophagus, assign N2 for mediastinal lymph node involvement, unless there is a statement of involvement by direct extension from the primary tumor

NAACCR Item

NAACCR #950

Clinical N	Clinical N Display	Description	Registrar Notes
cX	cNX	Regional lymph node(s) cannot be assessed	Clinical classification criteria met, evaluation done: Physician unable to assess N Regional lymph node involvement cannot be determined or findings inconclusive Physician assigns cNX, no other information available to determine N
c0	cN0	No regional lymph node metastasis
c1	cN1	Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension	Regional lymph nodes, ipsilateral: Bronchial Hilar (bronchopulmonary) (proximal lobar) (pulmonary root) Intrapulmonary nodes, including involvement by direct extension: Interlobar Lobar Segmental Subsegmental Peri/parabronchial Regional lymph node(s), NOS Lymph nodes, NOS Stated as N1
c2	cN2	Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s)	Regional lymph nodes, ipsilateral: Aortic (above diaphragm), NOS: Peri/para-aortic, NOS: Ascending aorta (phrenic) Subaortic (aortico-pulmonary window) Carinal (tracheobronchial) (tracheal bifurcation) Mediastinal, NOS: Anterior Posterior (tracheoesophageal) Pericardial Peri/paraesophageal Peri/paratracheal, NOS: Azygos (lower peritracheal) Pre- and retrotracheal, NOS: Precarinal Pulmonary ligament Subcarinal Stated as N2
c3	cN3	Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s)	Contralateral/bilateral hilar (bronchopulmonary) (proximal lobar) (pulmonary root) Contralateral/bilateral mediastinal Scalene (inferior deep cervical), ipsilateral or contralateral Supraclavicular (transverse cervical), ipsilateral or contralateral Stated as N3
88	88	Not applicable	Primary site/histology not TNM defined Death certificate only (DCO) case
<BLANK>	BLANK	See Registrar Notes	Clinical classification criteria not met Clinical classification criteria met, evaluation done: No information about diagnostic workup Results not documented in record Tumor first detected on surgical resection (no clinical workup) Evidence of metastatic disease [(cM1) or (pM1)], no other workup Only Clinical Stage Group documented (no T, N, or M information available)