Site-Specific Factor 8

Extracapsular Extension Clinically, Lymph Nodes for Head and Neck


**Note 1:** Clinical assessment can be by physical examination or imaging. According to AJCC, "ECS [extracapsular spread] can be diagnosed clinically by a matted mass of nodes adherent to overlying skin, adjacent soft tissue, or clinical evidence of cranial nerve invasion. Radiologic signs of ECS include amorphous, spiculated margins of a metastatic node and stranding of the perinodal soft tissue in previously untreated patients." (1) **Note 2:** Code the status of extracapsular extension assessed clinically for any involved regional lymph node(s) coded in Clinical N. Do not code extracapsular extension for any distant lymph node(s). **Note 3:** If nodes are involved clinically, and documentation of physical examination or imaging is available without a statement of extracapsular extension, use code 010. **Note 4:** If the only documentation is a reference to clinically involved nodes with no reference to extracapsular extension, use code 030. **Note 5:** If there is no information about clinical assessment of nodes, use code 999.




NAACCR #2862
Code Description
000 No regional lymph nodes involved clinically
010 Regional lymph node(s) involved clinically, no extracapsular extension clinically
020 Regional lymph node(s) involved clinically, extracapsular extension clinically (nodes described as fixed or matted)
030 Regional lymph node(s) involved clinically, unknown if extracapsular extension
988 Not applicable: Information not collected for this case
997 Clinical examination of regional lymph nodes performed, unknown results
998 No clinical examination of regional lymph nodes
999 Unknown if regional lymph nodes involved clinically, not stated
Regional lymph nodes cannot be assessed
Not documented in patient record
(1) American Joint Committee on Cancer., & Edge, S.B. (2010) *AJCC Cancer Staging Manual (7th ed.)*. New York; London: Springer, pg. 22