Grade Post Therapy Clin (yc)
**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:** Priority order for codes
- Urothelial cancers (WHO/ISUP grade): use codes L, H and 9
+ If only G1-G3 are documented, code 9
- Adenocarcinomas and Squamous Cell Carcinomas: use codes 1-3, 9
+ If only L or H are documented, code 9
**Note 5:** G3 includes undifferentiated and anaplastic.
**Note 6:** For bladder, a TURB qualifies for a clinical grade only.
**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