Grade Post Therapy Clin (yc) (NET Colon and Rectum (V9 2024+))

Data Item Details

Parent Schema: NET Colon and Rectum (V9 2024+)
NAACCR Item: #1068
NAACCR XML ID: gradePostTherapyClin

Notes

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 1-3 take priority over codes A-D.

• Grades A-D should only be used in the absence of a physician's statement of grade (G1, G2, G3) or no results for Ki-67 or Mitotic Count (See also Note 6)

Note 5 Do not code grade based on the following terminology

• Neuroendocrine carcinoma, low grade (8240/3)

• Neuroendocrine carcinoma, well differentiated (8240/3)

• Neuroendocrine carcinoma, moderately differentiated (8249/3)

• Poorly differentiated neuroendocrine carcinoma (8246/3)

Note 6 Code grade based on the physician's documentation (G1, G2, G3) OR in the absence of a physician's statement, code grade based on the Ki-67 and Mitotic Count.

• If a Ki-67 is documented as less than 3, many times the mitotic count is not done. In this situation, the Ki-67 alone is enough to code the grade (G1).

• Grades 2 and 3, are either/or for Ki-67 and Mitotic Count. You do not need both the Ki-67 and Mitotic Count to assign grade 2 or 3.

Note 7 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