Pathologic N

This input is used for staging

Notes

**Note 1:** Histological examination of a selective neck dissection specimen will ordinarily include 6 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:** This field includes all lymph nodes defined as Levels I-VI, retropharyngeal or superior mediastinal lymph nodes (Level VII). **Note 4:** 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 5:** 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 #890
Pathologic N Pathologic N Display Description Registrar Notes
pX pNX Regional lymph node(s) 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 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]
p1A pN1a Metastasis in Level VI
Pretracheal
Paratracheal
Prelaryngeal/Delphian lymph nodes
Level VI nodes - Anterior compartment group:

Stated as N1a
p1B pN1b 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
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
In situ case but no pTis is defined by TNM
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., 60