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Neuroblastoma staging

Staging of neuroblastoma as described by International Neuroblastoma Staging System (INSS) is for post-operative patients and is as follows 1

  • Stage 1
    • localised tumour
    • complete gross excision
    • contralateral nodes negative for tumour
    • microscopic residual or positive en-bloc (adherent) local nodes acceptable
  • Stage 2A
    • localised tumour
    • incomplete gross excision
    • contralateral nodes negative for tumour
  • Stage 2B
    • localised tumour
    • complete or incomplete resection
    • positive ipsilateral (non-adherent) nodes
    • contralateral nodes negative for tumour
  • Stage 3
    • unresectable lateral tumour that crosses the midline or
    • midline tumour or
    • contralateral nodes positive for tumour
  • Stage 4S
    • <1 year of age
    • localised tumour (stage 1, 2A or 2B)
    • distant metastases confined to skin, liver and/or bone marrow
  • Stage 4
    • distant metastases not fulfilling stage 4S

In the majority of cases (60-80%), patients present with stage 3 or 4 tumours 2.

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