Alternate Name	Item#	Length	Source of Standard	Column #
Scope of Regional Lymph Node Surgery at this Facility (CoC)	672	1	CoC	784-784

Description
Describes the removal, biopsy, or aspiration of regional lymph node(s) performed at the reporting facility for diagnosis and/or staging or as a part of the first course of therapy.

Rationale
This item is important for evaluating quality of care and treatment practices relating to initial diagnosis, staging and/or first course of therapy. If central registries wish to study the treatment given at particular facilities, the facility-level treatment fields must be used. The summary treatment fields, conversely, combine information for all hospitals that provide first course of treatment for the tumor. Facility-specific fields allow studies of detailed referral patterns and treatment by type of healthcare setting. Knowing the extent of treatment given at a particular facility also helps resolve consolidation issues.

If central registries wish to study the treatment given at particular hospitals, the hospital-level treatment fields must be used. The summary treatment fields, conversely, combine information across all hospitals that provide first course of treatment for the tumor. Hospital-specific fields allow studies of detailed referral patterns and treatment by type of hospital. Knowing the extent of treatment given at a particular hospital also helps resolve coding issues.

Codes (Refer to the most recent version of FORDS for additional instructions.)

0	No regional lymph nodes removed. No lymph nodes found in the pathologic specimen. Diagnosed at autopsy.
1	Biopsy or aspiration of regional lymph node, NOS.
2	Sentinel lymph node biopsy.
3	Regional lymph node(s) removed and the number of nodes removed is unknown or not stated; the procedure is not specified as sentinel node biopsy. Regional lymph nodes removed, NOS.
4	1 to 3 regional lymph nodes removed.
5	4 or more regional lymph nodes removed.
6	Sentinel node biopsy and code 3, 4, or 5 at same time or timing not stated.
7	Sentinel node biopsy and code 3, 4, or 5 at different times.
9	Unknown or not applicable. It is unknown whether regional lymph node surgery was performed. Death certificate only case; unknown or ill-defined primary site; hematopoietic, reticuloendothelial, ummunoproliferative or myeloproliferative disease.

Note: One important use of registry data is the tracking of treatment patterns over time. To
compare contemporary treatment to previously published treatment based on former codes, or to data unmodified from pre-1998 definitions, the ability to differentiate surgeries in which four or more regional lymph nodes are removed is desirable. However, it is very important to note that the distinction between codes 4 and 5 is made to permit comparison of current surgical procedures with procedures coded in the past when the removal of fewer than 4 nodes was not reflected in surgery codes. It is not intended to reflect clinical significance when applied to a particular surgical procedure. It is important to avoid inferring, by data presentation or other methods, that one category is preferable to another within the intent of these items.