Grade Post Therapy Clin (yc) (Bone Appendicular Skeleton)

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 Code 1 for stated as “low grade” only.

Note 5 Codes 1-3 take priority over H.

• If “high grade” is documented and G2 (Moderately differentiated, high grade) or G3 (Poorly differentiated, high grade) are not documented, code H (high grade, NOS)

Note 6 G3 includes undifferentiated and anaplastic.

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

Note 8 If you are assigning an AJCC Staging System stage group

• Grade is required to assign stage group

• Code H is treated as a G3 when assigning AJCC stage group

• An unknown grade may result in an unknown stage group