Clinical N

This input is used for staging

Notes

**Note 1:** Code only regional nodes and nodes, NOS in this field. Note 2 specifies when to code certain tumor deposits (TD) here. Distant nodes are coded in M (distant metastasis). **Note 2:** Per UICC, "Tumor deposits (satellites), i.e., macroscopic or microscopic nests or nodules, in the pericolorectal adipose tissue's lymph drainage area of a primary carcinoma without histological evidence of residual lymph node in the nodule, may represent discontinuous spread, venous invasion with extravascular spread (V1/2) or a totally replaced lymph node (N1/2). If such deposits are observed with lesions that would otherwise be classified as T1 or T2, then the T classification is not changed, but the nodule(s) is recorded as N1c. If a nodule is documented by the pathologist to be a totally replaced lymph node (generally having a smooth contour), it should be recorded as a positive lymph node and not as a satellite, and each nodule should be counted separately as a lymph node in the final pN determination." (1) **Note 3:** Assign N1 if regional lymph nodes are involved but there is no indication of the number of nodes involved. **Regional lymph nodes** **All colon sites** Colic [NOS] Epicolic (adjacent to bowel wall) Mesocolic [NOS] Mesenteric [NOS] Paracolic/pericolic Lymph nodes, NOS Regional lymph nodes, NOS **Cecum (C180)** Anterior (prececal) Cecal [NOS] Ileocolic Periappendiceal Posterior (retrocecal) Right colic **Ascending colon (C182)** Ileocolic Middle colic Right colic **Hepatic flexure (C183)** Middle colic Right colic **Transverse colon (C184)** Inferior mesenteric Left colic Middle colic Right colic **Splenic flexure (C185)** Inferior mesenteric Left colic Middle colic **Descending colon (C186)** Inferior mesenteric Left colic Sigmoid **Sigmoid colon (C187)** Inferior mesenteric Left colic Rectosigmoid Sigmoid Sigmoidal (sigmoid mesenteric) Superior haemorrhoidal (hemorrhoidal) Superior rectal

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 Metastasis in 1-3 regional lymph nodes Note: N1 has subcategories of N1a, N1b and N1c. Assign N1 only when there is no information available to assign one of the subcategories

Stated as N1 [NOS]
c1A cN1a Metastasis in 1 regional lymph node Stated as N1a
c1B cN1b Metastasis in 2-3 regional lymph nodes Stated as N1b
c1C cN1c Tumor deposit(s), i.e., satellites, in the subserosa, or in non-peritonealized pericolic or perirectal soft tissue without regional lymph node metastasis (See Note 2)

Stated as N1c
c2 cN2 Metastasis in 4 or more regional lymph nodes Note: N2 has subcategories of N2a and N2b. Assign N2 only when there is no information available to assign one of the subcategories

Stated as N2 [NOS]
c2A cN2a Metastasis in 4-6 regional lymph nodes Stated as N2a
c2B cN2b Metastasis in 7 or more regional lymph nodes Stated as N2b
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)
(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., 103