Abstract
Anatomic staging systems for neurobalstoma are important in determining tumor distribution, intensity of therapy required and patient prognosis. Classic staging has utilized two approaches: one defines the initial anatomic distribution of disease at diagnosis; the second includes considerations for degree of resectability of the primary tumor. Many currently used systems are generally incompatible and unable to distinguish patients in the intermediate prognastic groups. A new International Neuroblastoma Staging System (INSS) is proposed which combines components of initial distribution of disease as well as surgical resectability. Uniform evaluation of response to therapy is also part of the INSS. Biologic staging neuroblastoma may become important in the future and the INSS proposal allows enough flexibility to incorporate this into a more standardized classification system.
Similar content being viewed by others
References
American Joint Committee on CaNcer (1983) Neurobalstoma. In: Beahrs OH, Myers MH (eds) Manual for staging of cancer, 2nd edn. Lippincott, Philadelphia, pp 237–239
Brodeur GM, Seeger RC, Barrett A, Berthold F, Castleberry RP, D'Angio G, DeBernardi B, Evans AE, Favrot M, Freeman AI, Haase G, Hartmann O, Hayes FA, Helson L, Kemshead J, Lampert F, Ninane J, Ohkawa H, Philip T, Pinkerton CR, Pritchard J, Sawada T, Siegel S, Smith EI, Tsuchida Y, Voute PA (1988) International criteria for diagnosis, staging, and response to treatment in patients with neuroblastoma. J Clin Onconol 6: 1874–1881
Brodeur GM, Seeger RC, Barrett A, Berthold F, Castleberry RP, D'Angio G, DeBernardi B, Evans AE, Favrot M, Freeman AI, Haase G, Hartmann O, Hayes FA, Helson L, Kemshead J, Lampert F, Ninane J, Philip T, Pritchard J, Siegel S, Smith EI, Voute PA (1988) International criteria for diagnosis,staging and response to treatment in patients with neuroblastoma. Prog Clin Biol Res 271: 509–524
Carlsen NLT, Christensen IJ, Schroeder H, Bro PV, Hesselbjerg U, Jensen KB, Nielsen OH (1986) Prognostic value of different staging systems in neuroblastomas and completness of tumor excision. Arch Dis Child 61: 832–842
Cohen D (1969) Neuroblastoma: factors affecting survival. Z Kinderchir 6 [Suppl]: 389–395
de Bernardi B, Rogers D, Carli M, Madon E, de Laurentis T, Bagnulo S, di Tullo MT, Paolucci G, Pastore G (1987) Localized neuroblastoma. Surgical and pathologic staging. Cancer 60: 1066–1072
Evans AE, D'Angio GJ, Propert K, Anderson J, Hann HL (1987) Prognostic factors in neuroblastoma. Cancer 59: 1853–1859
Evans AE, D'Angio GJ, Randolph J (1971) A proposed staging for children with neuroblastoma. Cancer 27: 374–378
Evans AE, D'Angio GJ, Sather HN, deLorimier AA, Dalton A, Ungerleiden RS, Finklestein JZ, Hammond GD (1990) A comparison of four staging systems for localized and regional neuroblastoma: a report from the Children's Cancer Study Group. J Clin Oncol 8; 1–10
Haase GM, Wong KY, deLorimier A, Sather HN, Hammond GD (1989) Improvement in survival after excision of primary tumor in stage III neuroblastoma. J Pediatr Surg 24: 194–200
International Union Against Cancer (1987) Hermanek P, Sobin LH (eds) TNM classification of malignant tumors, 4th edn. Springer, Berlin Heidelberg New York pp 188–192
Hayes FA, Green A, Hustu HO, Kumar M (1983) Surgicopathologic staging of neuroblastoma: prognostic significance of regional lymph node metastases. J Pediatr 102: 59–62
James DH (1967) Proposed classification of neuroblastoma. J Pediatr 71: 764
Le Tourneau JN, Bernard JL, Hendren WH, Carcassonne M (1985) Evaluation of the role of surgery in 130 patients with neuroblastoma. J Pediatr Surg 20: 244–249
Look AT, Hayes FA, Nitschke R, McWilliams NB, Green AA (1984) Cellular DNA content as a predictor of response to chemotherapy in infants with unresectable neuroblastoma. N Engl J Med 311: 231–235
Matsumura M, Atkinson JB, Hays DM, Hammond GD, Siegel SE, Sather H, Grosfeld J, Haase G (1988) An evaluation of the role of surgery in metastatic neuroblastoma. J Pediatr Surg 23 (5): 448–453
Nagahara N, Ohkawa H, Suzuki H, Tsuchida Y, Nakajov T (1990) Staging of neuroblastoma. J Clin Oncol 8 (1): 179
Ninane J, Pritchard J, Morris Jones PH, Mann JR, Malpas JS (1982) Stage II neuroblastoma. Adverse prognostic significance of lymph node involvement. Arch Dis Child 57: 438–442
Nitschke R, Smith EI, Shochat S, Altshuler G, Travers H, Shuster JJ, Hayes FA, Patterson R, McWilliams N (1988) Localized neuroblastoma treated by surgery. A Pediatric Oncology Group study. J Clin Oncol 6: 1271–1279
Philip T, Helson L, Bernard J-L, Zucker JM, Kremens B, Favrot M, Hartmann O (1987) Definition of response and remission in children over one year of age with advanced neuroblastoma: proposition for a scoring system. Pediatr Hematol Oncol 4: 25–31
Pinkel D, Pratt C, Holton C, James Jr D, Wrenn Jr E, Hustu HO (1968) Survival of children with neuroblastoma treated with combination chemotherapy. J Pediatr 73: 928–931
Sandstdt B, Jereb B, Eklund G (1983) Prognostic factors in neuroblastoma. Acta Pathol Microbiol Immunol Scand (Sect A) 91: 365–371
Sawaguchi S, Suganama Y, Watanabe I, Tsuchida Y, Okabe I, Sawada T, Taguchi N, Takahushi H, Kinumaki H, Ise Y, Tsunoda A, Tsunoaka H, Veda T, Muta H (1980) Studies on the biological and clinical characteristiics of neuroblastoma. III. Nippon Shokaki Geka Gakkai Zasshi 16: 51–66
Seeger RC, Brodeur GM, Sather H, Dalton A, Siegel SE, Wong KY, Hammond D (1985) Association of multiple copies of the N-myc oncogene with rapid progression of neuroblastomas. N Engl J Med 313: 1111–1116
Shimada H, Chatten J, Newton WA, Sachs N, Hamoudi AB, Chiba T, Marsden HB, Misugi K (1984) Histopathologic prognostic factors in neuroblastic tumors: definition of subtypes of ganglioneuroblastoma and an age-lined classification of neuroblastomas. JNCI 73: 405–416
Smith EI, Haase GM, Seeger RC, Brodeur GM (1989) A surgical perspective on the current staging in neuroblastoma — the international neuroblastoma staging system proposal. J Pediatr Surg 24 (4): 386–390
Smith EI, Nitschke R, Shochat SJ, Hayes FA, Castleberry R, Green A, Altshuler G, Shuster J (1987) Lack of significance of involved lymph nodes attached to localized neuroblastoma. Proc ASCO 6: 219
Thurman WG, Donaldson M (1969) Current concept in the management of neuroblastoma.In: M. D. Anderson Hospital (ed) Neoplasia in childhood. Year Book Medical Publishers, Chicago, pp 175–181
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Haase, G.M. Staging systems for neuroblastoma: a look at the old and the new. Pediatr Surg Int 6, 14–18 (1991). https://doi.org/10.1007/BF00174877
Issue Date:
DOI: https://doi.org/10.1007/BF00174877