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:** Bilateral nodes are classified as regional nodes for tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. * Clinical assessment of bilateral 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:** In transit metastasis is defined as a tumor distinct from the primary lesion and located either between the primary lesion and the draining regional lymph nodes or distal to the primary lesion. * In transit metastasis is coded in N (regional lymph nodes) **Note 6:** Code isolated tumor cells (ITCs) as positive nodes. **Regional lymph nodes** Isolated tumor cells (ITCs) only SINGLE superficial inguinal (femoral) regional lymph node SINGLE inguinal node, NOS (unknown if superficial or deep) MULTIPLE or BILATERAL superficial inguinal (femoral) regional lymph nodes MULTIPLE or BILATERAL inguinal nodes, NOS (unknown if superficial or deep) Deep inguinal, NOS Node of Cloquet or Rosenmuller (highest deep inguinal) Pelvic lymph nodes (unilateral or bilateral) External iliac Internal iliac (hypogastric) Obturator Pelvic nodes in contiguous or secondary nodal basin Pelvic nodes, NOS


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 Note: N1 has subcategories of N1a and N1b. Assign N1 only when there is no information available to assign one of the subcategories

Regional lymph nodes, NOS
Lymph nodes, NOS

Stated as N1 [NOS]
p1A pN1a Microscopic metastasis
(clinically occult: cN0 + pN1)
Stated as N1a
p1B pN1b Macroscopic metastasis
(clinically apparent: cN1 + pN1)
Stated as N1b
p2 pN2 In-transit 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.
Includes cases with ITCs only and cases with regional lymph node involvement not stated

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

Stated as N2
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 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., 179