Neuroblastoma (staging)
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- updated 27 Aug 2023:
Nothing to disclose
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There are two methods of neuroblastoma staging, one that is based on post-operative patients (INSS) and and one developed for pre-treatment patients (INRGSS).
Staging
International Neuroblastoma Staging System (INSS)
This staging system is for post-operative patients and mainly for prognosis 1:
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stage 1
- localised tumour with complete gross excision with or without microscopic residual disease
- contralateral and representative ipsilateral regional lymph nodes negative for disease (nodes attached to and removed with primary tumour may be positive)
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stage 2a
- localised tumour with incomplete gross excision
- ipsilateral and contralateral nodes negative for tumour
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stage 2b
- localised tumour with complete or incomplete resection
- positive ipsilateral (non-adherent) nodes
- contralateral nodes negative for tumour
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stage 3
- unresectable lateral tumour that crosses the midline or
- localised tumour with contralateral regional lymph node involvement
- midline tumour with bilateral extension by infiltration or by lymph node involvement
- stage 4S ("special")
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stage 4
- distant metastases not fulfilling stage 4S
In the majority of cases (60-80%), patients present with stage 3 or 4 tumours 2.
International Neuroblastoma Risk Group Staging System (INRGSS)
The INRG was developed after INSS to formulate staging for pre-operative neuroblastoma 5,6:
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stage L1
- localised tumours confined to one body cavity and not involving image-defined risk factors (IDRFs)
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stage L2
- locoregional tumours involving one or more IDRFs
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stage M
- distant (remote) metastases (i.e. excludes metastases to local lymph node groups)
- excludes stage MS
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stage MS
- metastases in patients <18 months (some centres <12 months) confined to skin, liver and/or bone marrow
More than 20 image-defined risk factors (IDRF)have been extensively defined by the INRG 5,6, and these are outside the scope of this article.
-<p>There are two methods of <strong>neuroblastoma staging</strong>, one that is based on post-operative patients (INSS) and one developed for pre-treatment patients (INRGSS).</p><h4>Staging</h4><h5>International Neuroblastoma Staging System (INSS)</h5><p>This staging system is for post-operative patients and mainly for prognosis <sup>1</sup>:</p><ul>- +<p>There are two methods of <strong>neuroblastoma staging</strong>, one that is based on post-operative patients (INSS) and one developed for pre-treatment patients (INRGSS).</p><h4>Staging</h4><h5>International Neuroblastoma Staging System (INSS)</h5><p>This staging system is for post-operative patients and mainly for prognosis <sup>1</sup>:</p><ul>
-</ul><p>More than 20 <a href="/articles/neuroblastoma-image-defined-risk-factors">image-defined risk factors (IDRF) </a>have been extensively defined by the INRG <sup>5,6</sup>, and these are outside the scope of this article.</p>- +</ul><p>More than 20 <a href="/articles/neuroblastoma-image-defined-risk-factors">image-defined risk factors (IDRF) </a>have been extensively defined by the INRG <sup>5,6</sup>, and these are outside the scope of this article.</p>
Images Changes:
Image 1 CT (C+ portal venous phase) ( create )
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Case 1 - stage 4S
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1.