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:** Any finding of melanoma in lymph nodes, regardless of size and including isolated tumor cells (ITCs), are coded as positive lymph nodes. * Assign N1 If only ITCs are present **Note 3:** Bilateral or contralateral nodes are classified as regional nodes for head, neck, and truncal tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. Truncal tumors may also drain to both cephalad and caudal primary nodal basins as shown on lymphoscintigraphy. * Clinical assessment of bilateral/contralateral or cephalad/caudal regional nodal involvement is required for tumors where lymphoscintigraphy is not performed **Note 4:** Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins. Secondary basins are regional for TNM staging. **Note 5:** Assign N2c if there are satellite(s) or in-transit metastasis without regional lymph node involvement. Assign N3 if both satellite nodules/in-transit metastases and regional lymph nodes are present. **Regional lymph nodes by skin primary site** * Head and Neck sites include bilateral or contralateral nodes **Lip (C440)** Cervical Facial, NOS Buccinator (buccal) Nasolabial Mandibular, NOS Parotid, NOS Infra-auricular Preauricular Submental Submandibular (submaxillary) **External ear/auditory canal (C442)** Cervical Mastoid (post-/retro-auricular) (occipital) Preauricular **Face, Other (cheek, chin, forehead, jaw, nose and temple) (C443)** Cervical Facial, NOS Buccinator (buccal) Nasolabial Mandibular, NOS Parotid, NOS Infra-auricular Preauricular Submental Submandibular (submaxillary) **Scalp (C444)** Mastoid (post-/retro-auricular) (occipital) Parotid, NOS Infra-auricular Preauricular Spinal accessory (posterior cervical) **Neck (C444)** Axillary Mandibular, NOS Mastoid (post-/retro-auricular) (occipital) Parotid, NOS Infra-auricular Preauricular Spinal accessory (posterior cervical) Submental Supraclavicular (transverse cervical) **Trunk (C445)** Axillary Cervical Internal mammary (parasternal) Femoral (superficial inguinal) Supraclavicular (transverse cervical) **Arm/Shoulder (C446)** Axillary Epitrochlear for hand/forearm Spinal accessory for shoulder **Leg/Hip (C447)** Femoral (superficial inguinal) Popliteal for heel and calf **Bidirectional nodal involvement (includes bilateral or contralateral nodes)** Upper Trunk: Femoral (or cephalad/caudal drainage from primary tumor) Lower Trunk: Axillary (or cephalad/caudal drainage from primary tumor) **Secondary nodal basin involvement (includes bilateral or contralateral nodes)** Head and Neck: Supraclavicular Arm/Shoulder: Supraclavicular Leg/Hip: Iliac All sites: Regional lymph node(s) in secondary nodal basins, NOS

NAACCR Item

NAACCR #950
Clinical N Clinical N Display Description Registrar Notes
cX cNX Regional lymph nodes 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 No regional lymph node involvement
c1 cN1 Metastasis in one regional lymph node Regional lymph nodes, NOS
Lymph nodes, NOS

Stated as N1 [NOS]
c2 cN2 Metastasis in two or three regional lymph nodes or satellite(s) or in-transit metastasis Stated as N2 [NOS]
c2C cN2c Satellite(s) or in-transit metastasis WITHOUT regional nodal metastasis Satellite nodule(s) or in transit metastasis, distance from primary tumor less than or equal to 2 cm or distance not stated WITHOUT regional lymph node involvement.

Described as tumor with satellite nodule(s) or in transit metastasis, NOS WITHOUT regional lymph node involvement

Stated as N2c
c3 cN3 Metastasis in four or more regional lymph nodes, or matted metastatic regional lymph nodes, or satellite(s) or in-transit metastasis with metastasis in regional lymph node(s) Matted lymph nodes

Satellite nodule(s) or in-transit metastases WITH regional lymph nodes

Stated as N3
88 88 Not applicable 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)