Organization

Field Name

ID

Required

KCR

Grade Post Therapy Clin (yc)

30141

yes 

SEER

Grade Post Therapy Clin (yc)

1068

yes 

Note 1 Leave Grade Post Therapy Clin (yc) blank when

  • No neoadjuvant therapy
  • Clinical or pathological case only
  • Neoadjuvant therapy completed, no microscopic exam is done prior to surgery/resection of primary tumor
  • 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 microscopically sampled specimen of the primary site following neoadjuvant therapy or primary systemic/radiation therapy.

Note 3 If there are multiple tumors with different grades abstracted as one primary, code the highest grade.

Note 4 Codes L and H take priority over A-D.

Note 5 Code 9 (unknown) when

  • Microscopic exam is done after neoadjuvant therapy and grade from the primary site is not documented
  • Microscopic exam 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

L

LG: Low grade: round monomorphic nuclei with only mild to moderate nuclear size variation, indistinct nucleoli, and chromatin characteristics resembling those of normal parathyroid or of adenoma

H

HG: High grade: more pleomorphism, with a nuclear size variation greater than 4:1; prominent nuclear membrane irregularities; chromatin alterations, including hyperchromasia or margination of chromatin; and prominent nucleoli. High-grade tumors show several discrete confluent areas with nuclear changes

A

Well differentiated

B

Moderately differentiated

C

Poorly differentiated

D

Undifferentiated, anaplastic

9

Grade cannot be assessed (GX); Unknown

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See Note 1