Site-Specific Factor 4

Levels IV-V and Retropharyngeal Lymph Nodes for Head and Neck


**Note 1:** **Site-Specific Factors 3-6** are used to code the presence or absence of lymph node involvement in each of 7 different levels and other groups defined by TNM. The definitions of the levels are the same for all applicable head and neck sites. One digit is used to represent lymph nodes of a single level, with the digits of **Site-Specific Factor 3** representing lymph nodes of Levels I-III; the digits of **Site-Specific Factor 4** representing lymph nodes of Levels IV and V and the retropharyngeal nodes; the digits of **Site-Specific Factor 5** representing lymph nodes of Levels VI and VII and the facial nodes; and the digits of **Site-Specific Factor 6** representing the remaining Other groups as defined by TNM. In each digit, a code 1 means yes, the nodes are involved. **Note 2:** If involved regional node levels are documented as a range, or if the involved nodes overlap multiple levels, code all levels specified. **Note 3:** If regional node(s) are known to be positive but the level of node(s) involved is unknown, use code 000. **Note 4:** Levels IV - V are also referred to as * Level IV - Lower jugular group * Level V - Dorsal cervical nodes along the spinal accessory nerve and supraclavicular nodes (mostly Level IV)




NAACCR #2910


Code Description
000 No involvement in Levels IV or V or retropharyngeal lymph nodes
100 Level IV lymph node(s) involved
010 Level V lymph node(s) involved
001 Retropharyngeal nodes involved
110 Levels IV and V lymph nodes involved
101 Levels IV and retropharyngeal lymph nodes involved
011 Levels V and retropharyngeal lymph nodes involved
111 Levels IV and V and retropharyngeal lymph nodes involved
988 Not applicable: Information not collected for this case
999 Unknown if regional lymph nodes involved, not stated
Regional lymph nodes cannot be assessed
Not documented in patient record