Pathologic N

This input is used for staging


**Note 1:** Histological examination of a regional lymphadenectomy specimen will ordinarily include 16 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. Distant nodes are coded in M (distant metastasis). **Note 3:** Assign N1 if regional lymph nodes are involved but there is no indication of the number of nodes involved. **Note 4:** Assign as regional node metastases when there are metastatic nodules in the fat adjacent to a gastric carcinoma WITHOUT evidence of residual lymph node tissue; assign as M (distant metastases) for nodules implanted on peritoneal surfaces. **Regional lymph nodes** Celiac Hepatic Hepatoduodenal (for lesser curvature) Left gastric (superior gastric), NOS Cardial Cardioesophageal Gastric, left Gastropancreatic, left Lesser curvature Lesser omental Paracardial Nodule(s) in perigastric fat Pancreaticosplenic (pancreaticolienal) Pancreaticoduodenal Perigastric, NOS Peripancreatic Right gastric (inferior gastric), NOS Gastrocolic Gastroduodenal Gastroepiploic (gastro-omental), right or NOS Gastrohepatic Greater curvature Greater omental Pyloric, NOS: infrapyloric, subpyloric, suprapyloric Splenic (lienal), NOS Gastroepiploic (gastro-omental), left Splenic hilar Regional lymph nodes, NOS Lymph nodes, NOS


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
p1 pN1 Metastasis in 1-2 regional lymph nodes Regional lymph nodes, NOS
Lymph nodes, NOS

Stated as N1
p2 pN2 Metastasis in 3-6 regional lymph nodes Stated as N2
p3 pN3 Metastasis in 7 or more regional lymph nodes Note: N3 has subcategories of N3a and N3b. Assign N3 only when there is no information available to assign one of the subcategories

Stated as N3 [NOS]
p3A pN3a Metastasis in 7-15 regional lymph nodes Stated as N3a
p3B pN3b Metastasis in 16 or more regional lymph nodes Stated as N3b
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)
(1) International Union Against Cancer (UICC) *TNM Classification of Malignant Tumors,* 7th ed., Sobin, LH, Gospodarowicz, M, Wittekind, CH, eds. New York: Wiley, 2009, pg., 76