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:** This field includes all lymph nodes defined as Levels I-VI, retropharyngeal or superior mediastinal lymph nodes (Level VII). **Note 3:** Assignment of N value for thyroid does not depend on laterality. All codes for nodal involvement include ipsilateral, bilateral, contralateral, and midline lymph nodes. **Note 4:** The description of lymph nodes has been standardized across the head and neck schemas. All lymph node levels and groups listed here are regional nodes for TNM staging. **Level I** Level IA - Submental Level IB - Submandibular (submaxillary), sublingual **Level II - Upper jugular** Jugulodigastric (subdigastric) Upper deep cervical Level IIA - Anterior Level IIB - Posterior **Level III - Middle jugular** Middle deep cervical **Level IV - Lower jugular** Jugulo-omohyoid (supraomohyoid) Lower deep cervical Virchow node **Level V - Posterior triangle group** Posterior cervical Level VA - Spinal accessory Level VB - Transverse cervical, supraclavicular **Level VI - Anterior compartment group** Laterotracheal Paralaryngeal Paratracheal - above suprasternal notch Perithyroidal Precricoid (Delphian) Prelaryngeal Pretracheal - above suprasternal notch Recurrent laryngeal **Level VII - Superior mediastinal group (for other mediastinal nodes see M [distant metastasis])** Esophageal groove Paratracheal - below suprasternal notch Pretracheal - below suprasternal notch **Other groups** Cervical, NOS Deep cervical, NOS Facial Buccinator (buccal) Mandibular Nasolabial Internal jugular, NOS Parapharyngeal Parotid Infraauricular Intraparotid Periparotid Preauricular Retroauricular (mastoid) Retropharyngeal Suboccipital

NAACCR Item

NAACCR #950

Clinical N	Clinical N Display	Description	Registrar Notes
cX	cNX	Regional lymph node(s) 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	Regional lymph node metastasis	Note: N1 has subcategories of N1a and N1b. Assign N1 only when there is no information available to assign one of the subcategories Regional lymph nodes, NOS Lymph nodes, NOS Stated as N1 [NOS]
c1A	cN1a	Metastasis in Level VI Pretracheal Paratracheal Prelaryngeal/Delphian lymph nodes	Level VI nodes - Anterior compartment group: Stated as N1a
c1B	cN1b	Metastasis in other unilateral, bilateral or contralateral cervical Levels I, II, III, IV or V Retropharyngeal Superior mediastinal lymph nodes	Other Groups of lymph nodes Stated as N1b
88	88	Not applicable	Primary site/histology not TNM defined In situ case but no pTis is defined by TNM 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)