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)