TNM Path N, Reg Nodes Ex – Ed 7 (CoC)

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I’m having a problem with a Melanoma case with Pathologic TNM = pT4B pN2C cM0 Stage Grp 3C and Regional LN Exam = 00. The edit named “TNM Path N, Reg Nodes Ex – Ed 7 (CoC): If Regional Nodes Examined = 00 or 99, TNM Path N must = pX, c0, or blank” is failing.

I think there should be an exception for Melanoma pN2C added to this edit because N2C = Satellite(s) or in-transit metastasis WITHOUT regional nodal metastasis”, which means that regional lymph nodes do not have to be examined pathologically in order to assign pN2C. Regional LN Exam = 00 should be acceptable in this case.

Thanks for your help!

[Jim Hofferkamp]

Hi Tiffany,
I think the edit is correct. Per the CAnswer forum post below, lymph nodes still need to be removed to meet the rules for classification for pN2c.

http://cancerbulletin.facs.org/forums/forum/ajcc-tnm-staging/skin-chapters-29-31/68244-staging-for-intransit-mets-when-no-lns-were-removed

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