Data Last Updated: Oct. 15, 2024

Extranodal Extension Head and Neck Pathological

Description

Extranodal extension (ENE) is defined as “the extension of a nodal metastasis through the lymph node capsule into adjacent tissue” and is a prognostic factor for most head and neck tumors. This data item pertains to pathological staging extension. The presence of extranodal extension (ENE) from regional lymph nodes is an important prognostic factor in some cancers because these patients are rarely cured without some type of systemic chemotherapy or radiation. Extranodal extension is defined as metastatic tumor growing from within the lymph node outward through the lymph node capsule and into surrounding connective tissues. * “A regional node extending into a distant structure or organ is categorized as ENE and is not recorded as distant metastatic disease.” This data item for ENE that is detected pathologically for head and neck primaries.

Notes

**Note 1:** **Physician Statement** * Physician statement of extranodal extension (ENE) pathologically during a lymph node dissection or physician pathological stage indicating the absence or presence of ENE can be used to code this data item when no other information is available. **Note 2:** **Pathological assessment criteria** * Code the status of ENE assessed on histopathologic examination of surgically resected involved regional lymph node(s) * Do not code ENE from a lymph node biopsy (FNA, core, incisional, or the absence of ENE from a sentinel) * Do not code ENE for any distant lymph nodes
Code Description
0.0 Lymph nodes positive for cancer but ENE not identified or negative
0.1-9.9 ENE 0.1 to 9.9 mm
X.1 ENE 10 mm or greater
X.2 ENE microscopic, size unknown
Stated as ENE (mi)
X.3 ENE major, size unknown
Stated as ENE (ma)
X.4 ENE present, microscopic or major unknown, size unknown
X.7 Surgically resected regional lymph node(s) negative for cancer (pN0)
X.8 Not applicable: Information not collected for this case
(If this information is required by your standard setter, use of code X.8 may result in an edit error)
X.9 Not documented in medical record
No surgical resection of regional lymph node(s)
Non-invasive neoplasm (behavior /2)
ENE not assessed pathologically, or unknown if assessed
Pathological assessment of lymph node(s) not done, or unknown if done