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{
"id" : "clin_n_ddn",
"algorithm" : "tnm",
"version" : "1.6",
"name" : "Clin N Merkel Cell Skin",
"title" : "Clinical N",
"notes" : "**Note 1:** Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in M (distant metastasis).\n\n**Note 2:** Bilateral nodes are classified as regional nodes for tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. \n* Clinical assessment of bilateral regional nodal involvement is required for tumors where lymphoscintigraphy is not performed\n\n**Note 3:** Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins. Secondary basins are regional for TNM staging.\n\n**Note 4:** In transit metastasis is defined as a tumor distinct from the primary lesion and located either between the primary lesion and the draining regional lymph nodes or distal to the primary lesion.\n* In transit metastasis is coded in N (regional lymph nodes)\n\n**Note 5:** Code isolated tumor cells (ITCs) as positive nodes.\n\n**Regional lymph nodes**\n* Head and Neck sites include bilateral or contralateral nodes\n\n**Lip (C440)**\n \n Cervical\n Facial, NOS \n Buccinator (buccal) \n Nasolabial \n Mandibular, NOS \n Parotid, NOS \n Infra-auricular \n Preauricular \n Submental \n Submandibular (submaxillary) \n \n**External ear/auditory canal (C442)**\n \n Cervical\n Mastoid (post-/retro-auricular) (occipital) \n Preauricular \n \n**Face, Other (cheek, chin, forehead, jaw, nose and temple) (C443)** \n \n Cervical\n Facial, NOS \n Buccinator (buccal) \n Nasolabial \n Mandibular, NOS \n Parotid, NOS \n Infra-auricular \n Preauricular \n Submental\n Submandibular (submaxillary) \n \n**Scalp (C444)** \n \n Mastoid (post-/retro-auricular) (occipital) \n Parotid, NOS \n Infra-auricular \n Preauricular \n Spinal accessory (posterior cervical)\n \n**Neck (C444)**\n \n Axillary \n Mandibular, NOS \n Mastoid (post-/retro-auricular) (occipital) \n Parotid, NOS \n Infra-auricular \n Preauricular \n Spinal accessory (posterior cervical) \n Submental \n Supraclavicular (transverse cervical) \n \n**Trunk (C445)** \n \n Axillary \n Cervical \n Internal mammary (parasternal)\n Femoral (superficial inguinal) \n Supraclavicular (transverse cervical) \n \n**Arm/Shoulder (C446)**\n \n Axillary \n Epitrochlear for hand/forearm \n Spinal accessory for shoulder \n \n**Leg/Hip (C447)**\n \n Femoral (superficial inguinal) \n Popliteal for heel and calf \n \n \n \n **Bidirectional nodal involvement (includes bilateral or contralateral nodes)**\n\n Upper Trunk: Femoral (or cephalad/caudal drainage from primary tumor) \n Lower Trunk: Axillary (or cephalad/caudal drainage from primary tumor)\n \n**Secondary nodal basin involvement (includes bilateral or contralateral nodes)**\n \n Head and Neck: Supraclavicular \n Arm/Shoulder: Supraclavicular \n Leg/Hip: Iliac \n All sites: Regional lymph node(s) in secondary nodal basins, NOS",
"last_modified" : "2018-02-02T14:54:22.645Z",
"definition" : [ {
"key" : "clin_n",
"name" : "Clinical N",
"type" : "INPUT"
}, {
"key" : "clin_n_display",
"name" : "Clinical N Display",
"type" : "DESCRIPTION"
}, {
"key" : "description",
"name" : "Description",
"type" : "DESCRIPTION"
}, {
"key" : "notes",
"name" : "Registrar Notes",
"type" : "DESCRIPTION"
} ],
"rows" : [ [ "cX", "cNX", "Regional lymph nodes cannot be assessed", "Clinical classification criteria met, evaluation done: \n Physician unable to assess N\n Regional lymph node involvement cannot be determined or findings inconclusive\nPhysician assigns cNX, no other information available to determine N" ], [ "c0", "cN0", "No regional lymph node metastasis", "" ], [ "c1", "cN1", "Regional lymph node metastasis", "Isolated tumor cells (ITCs) only\n\nRegional lymph nodes, NOS\nLymph nodes, NOS\n\nStated as N1" ], [ "c2", "cN2", "In-transit metastasis", "Satellite nodule(s) or in transit metastasis, distance from primary tumor less than or equal to 2 cm or distance not stated WITH or WITHOUT regional lymph node involvement. \n Includes cases with ITCs only and cases with regional lymph node involvement not stated\n\nOR\n\nDescribed as tumor with satellite nodule(s), NOS WITH or WITHOUT regional lymph node involvement or regional lymph node involvement not stated\n\nStated as N2" ], [ "88", "88", "Not applicable", "Death certificate only (DCO) case" ], [ "", "BLANK", "See Registrar Notes", "Clinical classification criteria not met\nClinical classification criteria met, evaluation done:\n No information about diagnostic workup\n Results not documented in record\nTumor first detected on surgical resection (no clinical workup)\nEvidence of metastatic disease [(cM1) or (pM1)], no other workup\nOnly Clinical Stage Group documented (no T, N, or M information available)" ] ]
}
