Percent Necrosis Post Neoadjuvant
Description
Percent Necrosis Post Neoadjuvant is a prognostic factor for bone sarcomas. For osteosarcoma and Ewing’s sarcoma/PNET, response to neoadjuvant chemotherapy is a prognostic factor. Patients with more than 90% tumor necrosis have a more favorable prognosis than those with less response. The CAP protocol for bone tumor resection provides the pathologist with specific instructions for determining the percentage of tumor necrosis. A separate method (system of Picci) may describe response to treatment in grades: grade I (macroscopic viable tumor), grade II (microscopic viable tumor), or grade III (no viable tumor). Do not code the Picci grade system in this data item.Rationale
Percent Necrosis Post Neoadjuvant is a Registry Data Collection Variable for AJCC. It was previously collected as Bone, CS SSF #3.Additional Info
**Source documents:** pathology report **Other names include** Histologic treatment response, therapy response, chemotherapy effect **For further information**, refer to the **Bone** cancer protocol published by the College of American Pathologists for the AJCC Staging System *Bone*.Notes
**Note:** **Physician Statement** * Physician statement of microscopically confirmed Percent Necrosis Post Neoadjuvant Chemotherapy can be used to code this data item if no other documentation is available.Coding Guidelines
**1)** Record the highest percentage value of the tumor necrosis post neo-adjuvant therapy as stated by the pathologist or in the pathology report. * Code the value of the tumor necrosis to the nearest tenth of a percent **2)** **Codes 001.0-100.0**. Record the percentage value of tumor necrosis post neo-adjuvant chemotherapy as stated by the pathologist in the pathology report **3)** **Code XXX.9** when * Surgical resection of the primary site is the initial therapy; therefore, no neoadjuvant therapy was performed * Surgical resection of the primary site after neoadjuvant therapy is performed and there is no mention of percent necrosis| Code | Description |
|---|---|
| 0.0 | Tumor necrosis not identified/not present |
| 0.1-100.0 | 0.1 - 100.0 percent tumor necrosis (Percentage of tumor necrosis to nearest tenth of a percent) |
| XXX.2 | Tumor necrosis present, percent not stated |
| XXX.8 | Not applicable: Information not collected for this case If this item is required by your standard setter, use of code XXX.8 will result in an edit error. |
| XXX.9 | Not documented in medical record No histologic examined of primary site No neoadjuvant therapy No surgical resection of primary site is performed |