Organization |
Field Name |
ID |
Required |
---|---|---|---|
KCR |
Grade Post Therapy Path (yp) |
30138 |
yes |
SEER |
Grade Post Therapy Path (yp) |
3845 |
yes |
Note 1 Leave Grade Post Therapy Path (yp) blank when
- No neoadjuvant therapy
- Clinical or pathological case only
- Neoadjuvant therapy completed; surgical resection not done
- There is only one grade available and it cannot be determined if it is clinical, pathological, post therapy clinical or post therapy pathological
Note 2 Assign the highest grade from the resected primary tumor assessed after the completion of neoadjuvant therapy.
Note 3 If there are multiple tumors with different grades abstracted as one primary, code the highest grade.
Note 4 Codes 1-4 take priority over A-D, L and H.
Note 5 CNS WHO classifications use a grading scheme that is a "malignancy scale" ranging across a wide variety of neoplasms rather than a strict histologic grading system that can be applied equally to all tumor types.
- Code the WHO grading system for selected tumors of the CNS as noted in the AJCC 8th edition Table 72.2 when WHO grade is not documented in the record
+ A list of the histologies that have a default grade can also be found in the Brain/Spinal Cord CAP Protocol in Table 1 WHO Grading System for Some of the More Common Tumors of the CNS, Table 2 WHO Grading System for Diffuse Infiltrating Astrocytomas and Table 3 WHO Grading Meningiomas
https//www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocol-templates - For benign tumors ONLY (behavior 0), code 1 can be automatically assigned for all histologies
+ This was confirmed by the CAP Cancer Committee
Note 6 Use the grade from the post therapy clinical work up from the primary tumor in different scenarios based on behavior or surgical resection
- Behavior
- Tumor behavior for the post therapy clinical and the post therapy pathological diagnoses are the same AND the post therapy clinical grade is the highest grade
- Tumor behavior for post therapy clinical diagnosis is invasive, and the tumor behavior for the post therapy pathological diagnosis is in situ
- Surgical Resection
- Surgical resection is done of the primary tumor after neoadjuvant therapy is completed and there is no grade documented from the surgical resection
- Surgical resection is done of the primary tumor after neoadjuvant therapy is completed and there is no residual cancer
Note 7 Code 9 (unknown) when
- Surgical resection is done after neoadjuvant therapy and grade from the primary site is not documented
- Surgical resection is done after neoadjuvant therapy and there is no residual cancer
- Grade checked "not applicable" on CAP Protocol (if available) and no other grade information is available
Code |
Description |
---|---|
1 |
WHO Grade I : Circumscribed tumors of low proliferative potential associated with the possibility of cure following resection |
2 |
WHO Grade II: Infiltrative tumors with low proliferative potential with increased risk of recurrence |
3 |
WHO Grade III: Tumors with histologic evidence of malignancy, including nuclear atypia and mitotic activity, associated with an aggressive clinical course |
4 |
WHO Grade IV: Tumors that are cytologically malignant, mitotically active, and associated with rapid clinical progression and potential for dissemination |
L |
Stated as "low grade" NOS |
H |
Stated as "high grade" NOS |
A |
Well differentiated |
B |
Moderately differentiated |
C |
Poorly differentiated |
D |
Undifferentiated, anaplastic |
9 |
Grade cannot be assessed (GX); Unknown |
<BLANK> |
See Note 1 |