Neuroblastoma staging: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Mmir (talk | contribs)
CMEAdmin, CMEUser, Bureaucrats, bureaucrats, nocaptcha, smwadministrator, Administrators, Widget editors
14,850 edits
Mahshid
Line 4: Line 4:


==Overview==
==Overview==
*According to the conventional International Neuroblastoma Staging System (INSS), there are 6 stages of neuroblastoma based on the tumor size, lymph node involvement, and presence of metastesis. However, 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 according to the Children Oncology Group (COG) risk stratification system 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="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><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><ref name="gov">Neuroblastoma treatment–for health professionals. National Cancer Institute (2015) http://www.cancer.gov/types/neuroblastoma/hp/neuroblastoma-treatment-pdq#section/_1 Accessed on October, 8 2015</ref>
According to the conventional International Neuroblastoma Staging System (INSS), there are 6 stages of neuroblastoma based on the tumor size, lymph node involvement, and presence of metastesis. However, 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 according to the Children Oncology Group (COG) risk stratification system 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.


==Neuroblastoma Staging==
==Neuroblastoma Staging==

Revision as of 15:54, 18 February 2019

Neuroblastoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Neuroblastoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Neuroblastoma staging On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Neuroblastoma staging

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Neuroblastoma staging

CDC on Neuroblastoma staging

Neuroblastoma staging in the news

Blogs on Neuroblastoma staging

Directions to Hospitals Treating Neuroblastoma

Risk calculators and risk factors for Neuroblastoma staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

According to the conventional International Neuroblastoma Staging System (INSS), there are 6 stages of neuroblastoma based on the tumor size, lymph node involvement, and presence of metastesis. However, 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 according to the Children Oncology Group (COG) risk stratification system 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.

Neuroblastoma Staging

International Neuroblastoma Staging System (INSS)

  • According to the conventional International Neuroblastoma Staging System (INSS), there are 6 stages of neuroblastoma based on the tumor size, lymph node involvement, and presence of metastesis.[1][2][3]
Stage Description
Stage 1
  • Localized tumor
  • Complete gross excision
  • Ipsilateral lymph nodes involvement negative under microscopic examination
Stage 2A
  • Localized tumor
  • Incomplete gross resection
  • Ipsilateral lymph nodes involvement negative under microscopic examination
Stage 2B
  • Localized tumor
  • Complete or incomplete gross resection
  • Ipsilateral lymph nodes involvement positive under microscopic examination
  • Enlarged contralateral lymph nodes but with negative involvement under microscopic examination
Stage 3
  • Localized unilateral tumor with contralateral lymph nodes involvement positive under microscopic examination
or
  • Unresectable unilateral tumor infiltrating across the midline with positive or negative regional lymph node involvement
or
  • Unresectable midline tumor with bilateral infiltration or lymph node involvement
Stage 4
  • Metastasis of the tumor to distant lymph nodes
  • Metastasis of the tumor to liver, skin, bone and/or other organs (except as defined by Stage 4S)
Stage 4S
  • Limited to infants <1 year of age
  • Localized primary tumor (as defined for stage 1, 2A, or 2B)
  • Metastasis of the tumor limited to skin, liver and/or bone marrow
  • Bone marrow involvement in stage 4S should be minimal (<10% of total nucleated cells identified as malignant on bone marrow biopsy)

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
  • Localized disease without image-defined risk factors
Stage L2
  • Localized disease with image-defined risk factors
Stage M
  • Metastatic disease
Stage MS
  • Metastatic disease limited to skin, liver and/or bone marrow
  • Bone marrow involvement in stage MS should be minimal (<10% of total nucleated cells identified as malignant on bone marrow biopsy)

Risk Stratification

Children's Oncology Group Risk Stratification

  • Children Oncology Group (COG) risk stratification system determines the protocol of management used for neuroblastoma patients.[4]
  • Neuroblastoma patients are risk stratified into a low risk group, intermediate risk groups, and a high risk group based on the INSS stage, the patient's age, histological grade, and the amplification of MYCN gene.[2][3]


 
 
 
 
 
 
 
 
 
 
 
 
  • INSS stage 1
  • Irrespective of age
  • Irrespective of grade
  • Irrespective of molecular pathway
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Low risk neuroblastoma patients (group 1)
 
 
 
 
  • INSS stage 2A/2B (>50% resected)
  • Irrespective of age
  • Irrespective of grade
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • INNS stage 4S
  • <365 days of age
  • Favorable histology
  • DNA index >1
  • MYCN not amplified
 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 
 
 
 
  • INNS stage 2A/2B (<50% resected)
  • 0-12 years of age
  • Irrespective of grade
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • INSS stage 3
  • <365 days of age
  • Favorable histology
  • DNA index >1
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
Intermediate risk neuroblastoma patients (group 2)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • INNS stage 3
  • 1-12 years of age
  • Favorable histology
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • Symptomatic INNS stage 4S
  • <365 days of age
  • Favorable histology
  • DNA index >1
  • MYCN not amplified
 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 
 
 
 
 
  • INSS stage 3
  • <365 days of age
  • Unfavorable histology
  • DNA index=1
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Intermediate risk neuroblastoma patients (group 3)
 
 
 
 
  • INSS stage 4
  • <365 days of age
  • Favorable histology
  • DNA index >1
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • INNS stage 4S
  • <365 days of age
  • Unfavorable histology
  • DNA index=1
  • MYCN not amplified
 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 
 
 
 
 
  • INSS stage 4
  • <365 days of age
  • Unfavorable histology
  • DNA index=1
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Intermediate risk neuroblastoma patients (group 4)
 
 
 
 
  • INSS stage 3
  • 365-547 days of age
  • Unfavorable histology
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • INNS stage 4
  • 365-547 days of age
  • Favorable histology
  • DNA index>1
  • MYCN not amplified
 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 
 
 
 
  • INNS stage 2A/2B, Stage 3 , Stage 4 or Stage 4S
  • Irrespective of age
  • Irrespective of grade
  • MYCN amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • INSS stage 3
  • >547 days of age
  • Unfavorable histology
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
High risk neuroblastoma patients (group 5)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • INNS stage 4
  • 365-547 days of age
  • Unfavorable histology
  • DNA index=1
  • MYCN not amplified
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • INNS stage 4
  • >547 days of age
  • Irrespective grade
  • Irrespective MYCN amplification state
 
 
 
 
 
 
 
 

References

  1. ↑ 1.0 1.1 Neuroblastoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Neuroblastoma Accessed on October, 5 2015
  2. ↑ 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.
  3. ↑ 3.0 3.1 3.2 Colon NC, Chung DH (2011). "Neuroblastoma". Adv Pediatr. 58 (1): 297–311. doi:10.1016/j.yapd.2011.03.011. PMC 3668791. PMID 21736987.
  4. ↑ Neuroblastoma treatment–for health professionals. National Cancer Institute (2015) http://www.cancer.gov/types/neuroblastoma/hp/neuroblastoma-treatment-pdq#section/_1 Accessed on October, 8 2015


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Neuroblastoma_staging&oldid=1551111"