Grade
Grade is collected in 4 data items.
A listing of histologies and their respective grades can be found in the current CAP Protocol for the Brain and Spinal Cord. Cancer Protocol Templates | College of American Pathologists
.
| Data Item | Data Item # | Text Field # | Comments |
|---|---|---|---|
| Grade Clinical | 3843 | #2570 Text-Dx-Proc-Path | Information obtained from biopsy
|
| Grade Pathological | 3844 | #2570 Text-Dx-Proc-Path | Information obtained from surgical resection |
| Grade Post Therapy Clinical | 1068 | #2570 Text-Dx-Proc-Path | Information obtained from a bx or FNA after neoadjuvant therapy but prior to post neoadjuvant surgical resection |
| Grade Post Therapy Pathological | 3845 | #2570 Text-Dx-Proc-Path | Information obtained from post neoadjuvant surgical resection |
See Schemas | SSDI Data | (naaccr.org) (includes general instructions for Grade) or SEER*RSA (cancer.gov) for complete coding instructions for these data items.
- The grading of CNS tumors is based on the WHO Grading system, which is a 4-grade system that is a “malignancy scale” ranging across a wide variety of neoplasms rather than a strict histology grading system.
- Although the most common grades are 1-4, for some histologies (such as gliomas), they may also be defined as “low (grades 1 or 2)” or “high (grades 3 or 4).”
- Grades 1-4 take priority over L and H. Grades A-D should be used as a last resort.
- Grade is to be coded from the original tumor. Do not use grade information from metastatic tissue, or recurrences.
| Code | Grade 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 progression or recurrence |
| 3 | WHO Grade III: Tumors with histologic and/or molecular genetic evidence of malignancy that are associated with an aggressive clinical course |
| 4 | WHO Grade IV: Tumors with histologic and/or molecular genetic evidence of malignancy that are associated with the most aggressive clinical course and shorter overall survival |
| L | Stated as “low grade” NOS |
| H | Stated as “high grade” NOS |
| A | Well differentiated |
| B | Moderately differentiated |
| C | Poorly differentiated |
| D | Undifferentiated |
| 9 | Grade cannot be assessed (GX); Unknown |
For further information on coding grade for Brain, CNS Other, and Intracranial Gland, see the Grade Manual, Grade ID: 24.2 (cases diagnosed 2023+).
Grade Manual can be found at Schemas | SSDI Data
Updated: September 23, 2026
Suggested Citation
SEER Training Modules: Grade. U.S. National Institutes of Health, National Cancer Institute. Cited 24 September 2026. Available from: https://training.seer.cancer.gov.