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==Neuroblastoma Staging== | ==Neuroblastoma Staging== | ||
===International Neuroblastoma Staging System (INSS)=== | ===International Neuroblastoma Staging System (INSS)=== | ||
The staging of neuroblastoma is based on the International Neuroblastoma Staging System (INSS).<ref name="wiki">Neuroblastoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Neuroblastoma Accessed on October, 5 2015</ref> | The staging of neuroblastoma is based on the International Neuroblastoma Staging System (INSS).<ref name="wiki">Neuroblastoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Neuroblastoma Accessed on October, 5 2015</ref><ref name="pmid22248965">{{cite journal| author=Davidoff AM| title=Neuroblastoma. | journal=Semin Pediatr Surg | year= 2012 | volume= 21 | issue= 1 | pages= 2-14 | pmid=22248965 | doi=10.1053/j.sempedsurg.2011.10.009 | pmc=PMC3261589 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22248965 }} </ref> | ||
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===International Neuroblastoma Risk Group Staging System (INRGSS)=== | ===International Neuroblastoma Risk Group Staging System (INRGSS)=== | ||
According to the newly proposed International Neuroblastoma Risk Group Staging System (INRGSS), there are four stages of neuroblastoma based on the extent of dissemination and image findings.<ref name="wiki">Neuroblastoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Neuroblastoma Accessed on October, 5 2015</ref> | |||
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==Risk Stratification== | ==Risk Stratification== | ||
* Neuroblastoma patients are risk stratified into a low risk group, an intermediate risk group, and a high risk group based on the [[tumor]] INSS stage, | * Neuroblastoma patients are risk stratified into a low risk group, an intermediate risk group, and a high risk group based on the [[tumor]] INSS stage, the patient's age, tumor grade, and the amplification of ''MYCN'' gene.<ref name="pmid22248965">{{cite journal| author=Davidoff AM| title=Neuroblastoma. | journal=Semin Pediatr Surg | year= 2012 | volume= 21 | issue= 1 | pages= 2-14 | pmid=22248965 | doi=10.1053/j.sempedsurg.2011.10.009 | pmc=PMC3261589 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22248965 }} </ref> | ||
* '''Low risk neuroblastoma groups''' include: | * '''Low risk neuroblastoma groups''' include: | ||
:* Patients with stage 1 tumor irrespective of the age, grade, and molecular pathway | :* Patients with stage 1 tumor irrespective of the age, grade, and molecular pathway | ||
:* Patients with stage 2A/2B, irrespective of age, irrespective of grade, MYCN | :* Patients with stage 2A/2B (>50% resected), irrespective of age, irrespective of the grade, ''MYCN''not amplified | ||
:* Patients with Stage 4S, <365 days of age, favorable histology, DNA | :* Patients with Stage 4S, <365 days of age, favorable histology, DNA index >1 , ''MYCN'' not amplified | ||
* '''Intermediate risk neuroblastoma groups''' include: | * '''Intermediate risk neuroblastoma groups''' include: | ||
:* Patients with stage 1 tumor irrespective of the age, grade, and | :* '''Group 1''' | ||
::* Patients with stage 2A/2B (<50% resected or Bx only) tumor, 0-12 years of age, irrespective of the grade, ''MYCN''not amplified | |||
::* Patients with stage 3 tumor, <365 days of age, favorable histology, DNA index >1, ''MYCN''not amplified | |||
::* Patients with stage 3 tumor, 1-12 years of age, favorable histology, ''MYCN''not amplified | |||
::* Patients with symptomatic stage 4S, <365 days of age, favorable histology, DNA index >1, ''MYCN''not amplified | |||
:* '''Group 2''' | |||
::* Patients with stage 3 tumor, <365 days of age, unfavorable histology, DNA index=1, ''MYCN''not amplified | |||
::* Patients with stage 4 tumor, <365 days of age, favorable histology, DNA index >1, ''MYCN'' not amplified | |||
::* Patients with stage 4S tumor, <365 days of age, unfavorable histology, DNA index=1, ''MYCN'' not amplified | |||
:* '''Group 3''' | |||
::* Patients with stage 4 tumor, <365 days of age, unfavorable histology, DNA index=1, ''MYCN'' not amplified | |||
::* Patients with stage 3 tumor, 365-547 days of age, unfavorable histology, ''MYCN'' not amplified | |||
::* Patients with stage 4 tumor, 365-547 days of age, favorable histology, DNA index >1, ''MYCN'' not amplified | |||
* '''High risk neuroblastoma groups''' include: | |||
:* Patients with stage 2A/2B, 3, 4, or 4S tumor, irrespective of the age, irrespective of the grade, ''MYCN'' amplified | |||
:* Patients with stage 3 tumor, ≥ 547 days of age, unfavorable histology, ''MYCN'' not amplified | |||
:* Patients with stage 4 tumor, 365-547 days of age, unfavorable histology, DNA index=1, ''MYCN'' not amplified | |||
:* Patients with stage 4 tumor, >547 days of age, irrespective the grade and ''MYCN'' amplification state |
Latest revision as of 17:00, 7 October 2015
Neuroblastoma Staging
International Neuroblastoma Staging System (INSS)
The staging of neuroblastoma is based on the International Neuroblastoma Staging System (INSS).[1][2]
T | Description |
Stage 1 |
|
Stage 2A |
|
Stage 2B |
|
Stage 3 |
|
Stage 4 |
|
Stage 4S |
|
International Neuroblastoma Risk Group Staging System (INRGSS)
According to the newly proposed International Neuroblastoma Risk Group Staging System (INRGSS), there are four stages of neuroblastoma based on the extent of dissemination and image findings.[1]
Stage: | Description |
Stage L1 |
|
Stage L2 |
|
Stage M |
|
Stage MS |
|
Risk Stratification
- Neuroblastoma patients are risk stratified into a low risk group, an intermediate risk group, and a high risk group based on the tumor INSS stage, the patient's age, tumor grade, and the amplification of MYCN gene.[2]
- Low risk neuroblastoma groups include:
- Patients with stage 1 tumor irrespective of the age, grade, and molecular pathway
- Patients with stage 2A/2B (>50% resected), irrespective of age, irrespective of the grade, MYCNnot amplified
- Patients with Stage 4S, <365 days of age, favorable histology, DNA index >1 , MYCN not amplified
- Intermediate risk neuroblastoma groups include:
- Group 1
- Patients with stage 2A/2B (<50% resected or Bx only) tumor, 0-12 years of age, irrespective of the grade, MYCNnot amplified
- Patients with stage 3 tumor, <365 days of age, favorable histology, DNA index >1, MYCNnot amplified
- Patients with stage 3 tumor, 1-12 years of age, favorable histology, MYCNnot amplified
- Patients with symptomatic stage 4S, <365 days of age, favorable histology, DNA index >1, MYCNnot amplified
- Group 2
- Patients with stage 3 tumor, <365 days of age, unfavorable histology, DNA index=1, MYCNnot amplified
- Patients with stage 4 tumor, <365 days of age, favorable histology, DNA index >1, MYCN not amplified
- Patients with stage 4S tumor, <365 days of age, unfavorable histology, DNA index=1, MYCN not amplified
- Group 3
- Patients with stage 4 tumor, <365 days of age, unfavorable histology, DNA index=1, MYCN not amplified
- Patients with stage 3 tumor, 365-547 days of age, unfavorable histology, MYCN not amplified
- Patients with stage 4 tumor, 365-547 days of age, favorable histology, DNA index >1, MYCN not amplified
- High risk neuroblastoma groups include:
- Patients with stage 2A/2B, 3, 4, or 4S tumor, irrespective of the age, irrespective of the grade, MYCN amplified
- Patients with stage 3 tumor, ≥ 547 days of age, unfavorable histology, MYCN not amplified
- Patients with stage 4 tumor, 365-547 days of age, unfavorable histology, DNA index=1, MYCN not amplified
- Patients with stage 4 tumor, >547 days of age, irrespective the grade and MYCN amplification state
- ↑ 1.0 1.1 Neuroblastoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Neuroblastoma Accessed on October, 5 2015
- ↑ 2.0 2.1 Davidoff AM (2012). "Neuroblastoma". Semin Pediatr Surg. 21 (1): 2–14. doi:10.1053/j.sempedsurg.2011.10.009. PMC 3261589. PMID 22248965.