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 or contralateral nodes are 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 3:** Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins. Secondary basins are regional for TNM. **Note 4:** UICC only defines N2, while AJCC defines N2a, N2b, and N2c. If a record comes in with N2a, N2b, or N2c, reassign it to N2. N2 and the subcategories of N2 all stage the same way. **Note 5:** Size of the largest metastasis in a lymph node must be known to assign N. You may use a physician’s statement of the N category if this is the only information in the medical record. * If the size of the metastasis is not documented, determine the size of the largest involved lymph node as documented clinically * If the size of the lymph node(s) cannot be determined, assign N1 * Do not code the size of any node(s) assigned in M (distant metastasis) **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, NOSNAACCR 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 | Metastasis in a single lymph node, 3 cm or less in greatest dimension | IPSILATERAL positive regional lymph node(s), not stated if single or multiple Positive lymph nodes, not stated if ipsilateral, contralateral or bilateral Regional lymph nodes, NOS Lymph nodes, NOS Stated as N1 |
| c2 | cN2 | Metastasis in a single lymph node, more than 3 cm but not more than 6 cm in greatest dimension, or in multiple lymph nodes, none more than 6 cm in greatest dimension* | Multiple ipsilateral lymph nodes, NOS Bilateral or contralateral lymph nodes, NOS Stated as N2 (N2a, N2b, N2c, N2 [NOS]) |
| c3 | cN3 | Metastasis in a lymph node, more than 6 cm in greatest dimension | Stated as N3 |
| 88 | 88 | Not applicable | Primary site/histology not TNM defined 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) |