Pathologic N
This input is used for staging
Notes
**Note 1:** Histological examination of a regional lymphadenectomy specimen will ordinarily include 12 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. Note 3 specifies when to code certain tumor deposits (TD) here. Distant nodes are coded in M (distant metastasis). **Note 3:** Per UICC, "Tumor deposits (satellites), i.e., macroscopic or microscopic nests or nodules, in the pericolorectal adipose tissue's lymph drainage area of a primary carcinoma without histological evidence of residual lymph node in the nodule, may represent discontinuous spread, venous invasion with extravascular spread (V1/2) or a totally replaced lymph node (N1/2). If such deposits are observed with lesions that would otherwise be classified as T1 or T2, then the T classification is not changed, but the nodule(s) is recorded as N1c. If a nodule is documented by the pathologist to be a totally replaced lymph node (generally having a smooth contour), it should be recorded as a positive lymph node and not as a satellite, and each nodule should be counted separately as a lymph node in the final pN determination." (2) **Note 4:** Assign N1 if regional lymph nodes are involved but there is no indication of the number of nodes involved. **Regional lymph nodes** **All colon sites** Colic [NOS] Epicolic (adjacent to bowel wall) Mesocolic [NOS] Mesenteric [NOS] Paracolic/pericolic Lymph nodes, NOS Regional lymph nodes, NOS **Cecum (C180)** Anterior (prececal) Cecal [NOS] Ileocolic Periappendiceal Posterior (retrocecal) Right colic **Ascending colon (C182)** Ileocolic Middle colic Right colic **Hepatic flexure (C183)** Middle colic Right colic **Transverse colon (C184)** Inferior mesenteric Left colic Middle colic Right colic **Splenic flexure (C185)** Inferior mesenteric Left colic Middle colic **Descending colon (C186)** Inferior mesenteric Left colic Sigmoid **Sigmoid colon (C187)** Inferior mesenteric Left colic Rectosigmoid Sigmoid Sigmoidal (sigmoid mesenteric) Superior hemorrhoidal (hemorrhoidal) Superior rectalNAACCR Item
NAACCR #890| 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 | No tumor deposits (TD) |
| p1 | pN1 | Metastasis in 1-3 regional lymph nodes | Note: N1 has subcategories of N1a, N1b and N1c. Assign N1 only when there is no information available to assign one of the subcategories Stated as N1 [NOS] |
| p1A | pN1a | Metastasis in 1 regional lymph node | Stated as N1a |
| p1B | pN1b | Metastasis in 2-3 regional lymph nodes | Stated as N1b |
| p1C | pN1c | Tumor deposit(s), i.e., satellites in the subserosa, or in non-peritonealized pericolic or perirectal soft tissue WITHOUT regional lymph node metastasis |
(See Note 2) Stated as N1c |
| p2 | pN2 | Metastasis in 4 or more regional lymph nodes | Note: N2 has subcategories of N2a and N2b. Assign N2 only when there is no information available to assign one of the subcategories Stated as N2 [NOS] |
| p2A | pN2a | Metastasis in 4-6 regional lymph nodes | Stated as N2a |
| p2B | pN2b | Metastasis in 7 or more regional lymph nodes | Stated as N2b |
| 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 | Primary site/histology not TNM defined 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) |