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National Cancer Data Base - Data Dictionary PUF 2016

AJCC Pathologic N

PUF Data Item Name: 
NAACCR Item #: 
Alphanumeric, Uppercase
Identifies the pathologically-determined absence or presence or extent of regional lymph node (pN) metastasis as defined by the American Joint Committee on Cancer (AJCC).
Registry Coding Instructions: 

Refer to the applicable AJCC Cancer Staging Manual for coding rules.

Analytic Note: 

For cases diagnosed on or prior to December 31, 2003, this item was expected to be completed by an attending physician, though registry staff were frequently involved in the determination of the information coded in this item though the review of full range of clinical and patient notes available to registry staff. For cases diagnosed January 1, 2004, through December 31, 2007, the CoC required registries to copy the staging elements from a standardized document found in the patient record, as recorded by the managing physician.

Beginning with 2008 diagnoses, the rules changed again. Physicians were no longer required to stage, but cancer committees in CoC programs were required to devise plans to ascertain that staging was used appropriately to make treatment decisions. Registries were encouraged to record physician staging when it was available, but were not required to do so. The CoC determined tha the stage groups derived from the Collaborative Stage Data Collection System met the criteria expected of pathologic staging, in providing a AJCC "final stage". PUF users are likely to see a decrease in the completeness of pathologic staging recorded in the "AJCC" staging items in the years following 2008.

Cases are coded using the AJCC Cancer Staging Manual edition in use during the year in which the case was diagnosed. Consult the appropriate edition of this manual for organ or site specific codes and their definitions. See AJCC TNM Edition Number (NAACCR Item #1060). Prior to implementation of the 5th edition of the manual, some "slippage" in version was allowed, such that some codes for cases diagnosed the year prior to implementation of a given edition and the year following its replacement may also have codes from the edition.

Codes on this list comprise all codes valid for any AJCC manual through the 7th edition and for any chapter. Please consult the applicable manual and chapter for codes that are valid for specific site, histology and AJCC edition combinations. Starting with the 2015 PUF (released in Fall 2017), pathologic N has been backward converted to include p prefixes.

There is no standard mechanism to recode AJCC items from one edition to another. Careful review of the individual definitions in the respective AJCC manuals is necessary before combining or comparing data across two or more AJCC editions.

Code Definition
Blank Not available in patient record. Not collected (2008+)
pX pNX
p0 pN0
p0I- pN0i-
p0I+ pN0i+
p0M- pN0m-
p0M+ pN0m+
p1MI pN1mi
p0A pN0a
p0B pN0b
p1 pN1
p1A pN1a
p1B pN1b
p1C pN1c
p2 pN2
p2A pN2a
p2B pN2b
p2C pN2c
p3 pN3
p3A pN3a
p3B pN3b
p3C pN3c
p4 pN4
88 Not applicable