Sandbox:staging
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 |
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Stage 2A |
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Stage 2B |
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Stage 3 |
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Stage 4 |
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Stage 4S |
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International Neuroblastoma Risk Group Staging System (INRGSS)
Stage: | Description |
Stage L1 |
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Stage L2 |
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Stage M |
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Stage MS |
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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.