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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. | ||
* '''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 | :* '''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 | |||
2A/2B (<50% resected or Bx only) | ::* 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''' | |||
3 | ::* Patients with stage 3 tumor, <365 days of age, unfavorable histology, DNA index=1, MYCN not amplified | ||
<365 days | ::* 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 | |||
3 | :* '''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 | |||
4S | ::* Patients with stage 4 tumor, 365-547 days of age, favorable histology, DNA index >1, MYCN not amplified | ||
<365 days | |||
<365 days | |||
4 | |||
<365 days | |||
4S | |||
<365 days | |||
<365 days | |||
3 | |||
365 - | |||
4 | |||
365 - | |||
* '''High risk neuroblastoma groups''' include: | * '''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 | |||
2A/2B, 3, 4, 4S | :* 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 | |||
MYCN | |||
3 | |||
≥ 547 days | |||
4 | |||
365 - | |||
4 | |||
> 547 days | |||
Revision as of 16:45, 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)
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.
- 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, MYCN not 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, 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
- ↑ Neuroblastoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Neuroblastoma Accessed on October, 5 2015
- ↑ Davidoff AM (2012). "Neuroblastoma". Semin Pediatr Surg. 21 (1): 2–14. doi:10.1053/j.sempedsurg.2011.10.009. PMC 3261589. PMID 22248965.