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:** 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 3:** Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins. Secondary basins are regional for TNM staging. **Note 4:** 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 5:** Code isolated tumor cells (ITCs) as positive nodes. **Regional lymph nodes** * 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
c1 cN1 Regional lymph node metastasis Isolated tumor cells (ITCs) only

Regional lymph nodes, NOS
Lymph nodes, NOS

Stated as N1
c2 cN2 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 WITH or WITHOUT regional lymph node involvement.
Includes cases with ITCs only and cases with regional lymph node involvement not stated

OR

Described as tumor with satellite nodule(s), NOS WITH or WITHOUT regional lymph node involvement or regional lymph node involvement not stated

Stated as N2
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)