Extranodal Extension Pathological
Notes
**Note 1:** Physician statement of Extranodal Extension (ENE) Pathological or physician pathological staging can be used to code this data item when there is no other information available. **Note 2:** Extranodal extension is defined as "the extension of a nodal metastasis through the lymph node capsule into adjacent tissue." ENE is the preferred terminology. Other names include: extranodal spread, extracapsular extension, or extracapsular spread." * "A regional node extending into a distant structure or organ is categorized as ENE and is not recorded as distant metastatic disease." **Note 3:** Be aware that the rules for coding ENE for head and neck sites compared to non-head and neck sites are different. **Note 4:** Code the status of extranodal extension assessed on the **surgical resection** specimen for the most involved regional lymph node(s). Do not code ENE for any distant lymph nodes. Code the status of ENE based on the following criteria * Code 0 * Absence of ENE, positive lymph nodes assessed by lymph node dissection * 1292: Scope of Regional Lymph Node Surgery must be 3-7 * Code 1 * Presence of ENE assessed by Sentinel Lymph Node biopsy * Presence of ENE assessed by lymph node dissection * 1292: Scope of Regional Lymph Node Surgery must be 2-7 * Code 7 * Lymph nodes negative for cancer assessed by Sentinel lymph node biopsy or lymph node dissection * 1292: Scope of Regional Lymph Node Surgery must be 2-7 * Code 9 * Absence of ENE, positive lymph nodes assessed by Sentinel Lymph Node biopsy * A positive Sentinel Lymph Node biopsy cannot assess the absence of ENE, only the presence of it. This is because there is not enough surrounding tissue in a Sentinel Lymph node biopsy to accurately assess ENE * If codes 1 or 7 are used, this indicates that the lymph nodes were surgically resected or a Sentinel Lymph Node biopsy was done and Scope of Regional Lymph Node Surgery [NAACCR Data Item: 1292] must be 2-7| Code | Description |
|---|---|
| 0 | Regional lymph node(s) involved, ENE not present/not identified from surgical resection |
| 1 | Regional lymph node(s) involved, ENE present/identified from surgical resection |
| 7 | No lymph node involvement identified from surgical resection (pN0) |
| 8 | Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 8 may result in an edit error) |
| 9 | Not documented in medical record No surgical resection of regional lymph node(s) Non-invasive neoplasm (behavior /2) Cannot be determined Pathological assessment of lymph node(s) not done, or unknown if done Extranodal Extension Pathological not assessed or unknown if assessed |