04-28-2023 Inaccessible Lymph Nodes
Scenario 2023:
- DRE (-) PSA 5.6
- Needle biopsy Prostate + Gleason 3+3 Adenocarcinoma
- No Scans done
- Physician Staged cT1c cN0 cM0 Stage 1-Patient opted for “watchful waiting”
Question: This is a site with inaccessible lymph nodes, how will you assign EOD Regional Nodes without a scan, scope, or surgical evaluation of regional lymph nodes?
• 000 No regional lymph node involvement
• 999 Unknown; regional lymph node(s) not stated/Regional lymph node(s) cannot be assessed/Not documented in medical record
Answer: 000 No regional lymph node involvement
EOD 2018 General Instructions page 23 https://seer.cancer.gov/tools/staging/eod/
Inaccessible lymph nodes: For certain primary sites, regional lymph nodes are not easily examined by palpation, observation, physical examination, or other clinical methods. These are lymph nodes within body cavities that in most situations cannot be palpated, making them inaccessible. Bladder, colon, corpus uteri, esophagus, kidney, liver, lung, ovary, prostate, and stomach are examples of inaccessible sites (this is not an all-inclusive list). When EOD Primary Tumor is low stage/Localized and standard treatment is done, it is sufficient to code 000 for negative regional lymph nodes.
