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{
"id" : "pathologic_n_head_neck_melanoma_copy_75380",
"algorithm" : "tnm",
"version" : "1.6",
"name" : "Pathologic N Head & Neck Melanoma",
"title" : "Pathologic N",
"notes" : "**Note 1:** Histological examination of a regional lymphadenectomy 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)\n\n**Note 2:** If laterality of lymph nodes is not specified, assume nodes are ipsilateral. \n* Midline nodes are assigned as ipsilateral\n\n**Note 3:** The description of lymph nodes has been standardized across the head and neck schemas. All lymph node levels and groups listed here are assigned as regional nodes for TNM staging.\n\n **Level I**\n \n Level IA - Submental\n Level IB - Submandibular (submaxillary), sublingual\n**Level II - Upper jugular** \n\n Jugulodigastric (subdigastric)\n Upper deep cervical \n Level IIA - Anterior\n Level IIB - Posterior \n**Level III - Middle jugular**\n\n Middle deep cervical\n**Level IV - Lower jugular**\n\n Jugulo-omohyoid (supraomohyoid)\n Lower deep cervical \n Virchow node\n**Level V - Posterior triangle group**\n\n Posterior cervical\n Level VA - Spinal accessory \n Level VB - Transverse cervical, supraclavicular \n**Level VI - Anterior compartment group**\n\n Laterotracheal\n Paralaryngeal\n Paratracheal - above suprasternal notch\n Perithyroidal\n Precricoid (Delphian)\n Prelaryngeal\n Pretracheal - above suprasternal notch\n Recurrent laryngeal\n**Level VII - Superior mediastinal group (for other mediastinal nodes see M [distant metastasis])**\n\n Esophageal groove\n Paratracheal - below suprasternal notch\n Pretracheal - below suprasternal notch \n**Other groups**\n\n Cervical, NOS\n Deep cervical, NOS\n Facial\n Buccinator (buccal)\n Mandibular\n Nasolabial\n Internal jugular, NOS\n Parapharyngeal \n Parotid\n Infraauricular\n Intraparotid\n Periparotid\n Preauricular\n Retroauricular (mastoid)\n Retropharyngeal\n Suboccipital\n\n Regional lymph nodes, NOS\n Lymph nodes, NOS\n\n**Note 4:** For head and neck schemas, additional information about lymph nodes (size of involved nodes, extracapsular extension, levels involved, and location of involved nodes above or below the lower border of the cricoid cartilage) is coded in **Site-Specific Factors 1, 3-9**.\n\n**Note 5:** For head and neck cancers, if lymph nodes are described only as \"supraclavicular\", try to determine if they are in Level IV (deep to the sternocleidomastoid muscle, in the lower jugular chain) or Level V (in the posterior triangle, inferior to the transverse cervical artery) and code appropriately. \n* If the specific level cannot be determined, assign them as Level V nodes",
"footnotes" : "(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., 52",
"last_modified" : "2018-02-02T14:54:21.424Z",
"definition" : [ {
"key" : "path_n",
"name" : "Pathologic N",
"type" : "INPUT"
}, {
"key" : "path_n_display",
"name" : "Pathologic N Display",
"type" : "DESCRIPTION"
}, {
"key" : "description",
"name" : "Description",
"type" : "DESCRIPTION"
}, {
"key" : "notes",
"name" : "Registrar Notes",
"type" : "DESCRIPTION"
} ],
"rows" : [ [ "pX", "pNX", "Regional lymph nodes cannot be assessed", "Pathologic classification criteria met, evaluation done:\n Physician unable to assess N\n Surgical resection primary tumor, no regional lymph nodes removed\n Involvement of regional lymph nodes not documented\nPhysician assigns pNX, no other information available to determine N" ], [ "p0", "pN0", "No regional lymph nodes metastasis", "" ], [ "p1", "pN1", "Regional lymph node metastasis", "Regional lymph nodes, NOS\nLymph nodes, NOS\n\nStated as N1" ], [ "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", "In situ case but no pTis is defined by TNM\nDeath certificate only (DCO) case" ], [ "", "BLANK", "See Registrar Notes", "Pathologic classification criteria not met \nNo surgical resection of primary tumor and there isn’t a positive biopsy of a structure in the highest T category and highest N category\nEvidence of metastatic disease (pM1), no other workup\nOnly Pathologic Stage Group documented (no T, N, or M information available)" ] ]
}
