Neuroblastoma staging: Difference between revisions
Line 86: | Line 86: | ||
===Children's Oncology Group Risk Stratification=== | ===Children's Oncology Group Risk Stratification=== | ||
* Neuroblastoma patients are risk stratified into a low risk group, an intermediate risk group, and a high risk group based on the INSS stage, the patient's age, histological 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><ref name="pmid21736987">{{cite journal| author=Colon NC, Chung DH| title=Neuroblastoma. | journal=Adv Pediatr | year= 2011 | volume= 58 | issue= 1 | pages= 297-311 | pmid=21736987 | doi=10.1016/j.yapd.2011.03.011 | pmc=PMC3668791 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21736987 }} </ref> | * Neuroblastoma patients are risk stratified into a low risk group, an intermediate risk group, and a high risk group based on the INSS stage, the patient's age, histological 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><ref name="pmid21736987">{{cite journal| author=Colon NC, Chung DH| title=Neuroblastoma. | journal=Adv Pediatr | year= 2011 | volume= 58 | issue= 1 | pages= 297-311 | pmid=21736987 | doi=10.1016/j.yapd.2011.03.011 | pmc=PMC3668791 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21736987 }} </ref> | ||
* '''Low risk neuroblastoma | * '''Low risk neuroblastoma patients''' 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 (>50% resected), irrespective of age, irrespective of the grade, ''MYCN''not amplified | :* 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 index >1 , ''MYCN'' not amplified | :* Patients with Stage 4S, <365 days of age, favorable histology, DNA index >1 , ''MYCN'' not amplified | ||
* '''Intermediate risk neuroblastoma | * '''Intermediate risk neuroblastoma patients''' include: | ||
:* '''Group 1''' | :* '''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 2A/2B (<50% resected or Bx only) tumor, 0-12 years of age, irrespective of the grade, ''MYCN''not amplified | ||
Line 106: | Line 106: | ||
::* Patients with stage 4 tumor, 365-547 days of age, favorable histology, DNA index >1, ''MYCN'' not amplified | ::* Patients with stage 4 tumor, 365-547 days of age, favorable histology, DNA index >1, ''MYCN'' not amplified | ||
* '''High risk neuroblastoma | * '''High risk neuroblastoma patients''' include: | ||
:* Patients with stage 2A/2B, 3, 4, or 4S tumor, irrespective of the age, irrespective of the grade, ''MYCN'' amplified | :* 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 3 tumor, ≥ 547 days of age, unfavorable histology, ''MYCN'' not amplified |
Revision as of 01:02, 10 October 2015
Neuroblastoma Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Neuroblastoma staging On the Web |
American Roentgen Ray Society Images of Neuroblastoma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
The staging of neuroblastoma is based on the International Neuroblastoma Staging System (INSS). According to a newly proposed International Neuroblastoma Risk Group Staging System (INRGSS), there are four stages of neuroblastoma based on the extent of dissemination and image findings. 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.[1][2][3]
Neuroblastoma Staging
International Neuroblastoma Staging System (INSS)
The staging of neuroblastoma is based on the International Neuroblastoma Staging System (INSS).[1][2][3]
T | Description |
Stage 1 |
|
Stage 2A |
|
Stage 2B |
|
Stage 3 |
|
Stage 4 |
|
Stage 4S |
|
International Neuroblastoma Risk Group Staging System (INRGSS)
According to a 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][3]
Stage | Description |
Stage L1 |
|
Stage L2 |
|
Stage M |
|
Stage MS |
|
Risk Stratification
Children's Oncology Group Risk Stratification
- Neuroblastoma patients are risk stratified into a low risk group, an intermediate risk group, and a high risk group based on the INSS stage, the patient's age, histological grade, and the amplification of MYCN gene.[2][3]
- Low risk neuroblastoma patients 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 patients 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, MYCN not 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, 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 patients 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, MYCN amplification state
References
- ↑ 1.0 1.1 1.2 Neuroblastoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Neuroblastoma Accessed on October, 5 2015
- ↑ 2.0 2.1 2.2 Davidoff AM (2012). "Neuroblastoma". Semin Pediatr Surg. 21 (1): 2–14. doi:10.1053/j.sempedsurg.2011.10.009. PMC 3261589. PMID 22248965.
- ↑ 3.0 3.1 3.2 3.3 Colon NC, Chung DH (2011). "Neuroblastoma". Adv Pediatr. 58 (1): 297–311. doi:10.1016/j.yapd.2011.03.011. PMC 3668791. PMID 21736987.