Collaborative Stage

Note 1: AJCC requires that nodes be designated as involving upper or lower levels within the neck. The boundary between upper and lower levels is the lower border of the cricoid cartilage.
Note 2: Nodes in Levels I, II, and III are upper level nodes. Nodes in Level IV and VII are lower level nodes. Level VA nodes are upper level nodes, and Level VB are lower level nodes. Level VI nodes span both upper and lower levels. Nodes included in "Other groups" (Facial, Parotid, Parapharyngeal, Retropharyngeal, Retroauricular, and Suboccipital) are all upper level nodes.
Note 3: Code the location of nodal involvement in relation to the lower border of the cricoid cartilage of all involved nodes, whether assessed clinically or pathologically, as stated by a physician.
Note 4: If there is no physician statement of upper and/or lower level nodal involvement, assign levels I, II, III, and VA nodes to upper level. Assign level IV, VB, and VII to lower level. If Level V (A and B not specified) and/or Level VI nodes are involved with no further information about location, use code 040.
Note 5: A description of "mid neck" requires clarification with the physician. Code 040, unknown level, if "mid neck" is the only information available.

Code	Description
000	No lymph nodes involved
010	Upper level lymph nodes involved (all involved nodes above the lower border of the cricoid cartilage)
020	Lower level lymph nodes involved (all involved nodes below the lower border of the cricoid cartilage)
030	Upper and lower level lymph nodes involved (all involved nodes both above and below the lower border of the cricoid cartilage)
040	Unknown level lymph nodes involved (unable to determine if involved nodes above or below the lower border of the cricoid cartilage)
988	Not applicable: Information not collected for this case
999	Unknown if regional lymph node(s) involved, not stated Not documented in patient record

CS Site-Specific Factor 7
Upper and Lower Cervical Node Levels