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Children oncology group (COG) risk stratification system determines the protocol of management used for neuroblastoma patients. Low risk neuroblastoma patients are managed with either observation or surgical resection of the tumor. Intermidiate risk neuroblastoma patients are managed with neoadjuvant chemotherapy in advance of a definitive surgical resection. Whereas high risk neuroblastoma patients are managed with a combination of surgery, chemotherapy, radiation therapy, hematopoietic stem cell transplantation, and immunotherapy.


Low risk neuroblastoma patients are managed with either observation or surgical resection of the tumor. Intermediate risk neuroblastoma patients are managed with neoadjuvant chemotherapy in advance of a definitive surgical resection. High risk neuroblastoma patients are managed with a combination of surgery, chemotherapy, radiation therapy, hematopoietic stem cell transplantation, and immunotherapy.

Children's Oncology Group Risk Stratification


 
 
 
 
 
Children's oncology group risk stratification
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Low risk patients
 
Intermediate risk patients
 
High risk patients
 
 
 
 
Craniospinal radiation
OR
Chemoradiotherapy followed by additional chemotherapy
 
Craniospinal radiation followed by chemotherapy
 
Craniospinal radiation followed by chemotherapy