Skip to main content
Log in

Staging systems for neuroblastoma: a look at the old and the new

  • Main Topic
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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

    Google Scholar 

  2. 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

    Google Scholar 

  3. 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

    Google Scholar 

  4. 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

    Google Scholar 

  5. Cohen D (1969) Neuroblastoma: factors affecting survival. Z Kinderchir 6 [Suppl]: 389–395

    Google Scholar 

  6. 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

    Google Scholar 

  7. Evans AE, D'Angio GJ, Propert K, Anderson J, Hann HL (1987) Prognostic factors in neuroblastoma. Cancer 59: 1853–1859

    Google Scholar 

  8. Evans AE, D'Angio GJ, Randolph J (1971) A proposed staging for children with neuroblastoma. Cancer 27: 374–378

    Google Scholar 

  9. 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

    Google Scholar 

  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

    Google Scholar 

  11. 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

    Google Scholar 

  12. 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

    Google Scholar 

  13. James DH (1967) Proposed classification of neuroblastoma. J Pediatr 71: 764

    Google Scholar 

  14. 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

    Google Scholar 

  15. 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

    Google Scholar 

  16. 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

    Google Scholar 

  17. Nagahara N, Ohkawa H, Suzuki H, Tsuchida Y, Nakajov T (1990) Staging of neuroblastoma. J Clin Oncol 8 (1): 179

    Google Scholar 

  18. 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

    Google Scholar 

  19. 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

    Google Scholar 

  20. 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

    Google Scholar 

  21. 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

    Google Scholar 

  22. Sandstdt B, Jereb B, Eklund G (1983) Prognostic factors in neuroblastoma. Acta Pathol Microbiol Immunol Scand (Sect A) 91: 365–371

    Google Scholar 

  23. 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

    Google Scholar 

  24. 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

    Google Scholar 

  25. 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

    Google Scholar 

  26. 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

    Google Scholar 

  27. 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

    Google Scholar 

  28. 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

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints 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

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00174877

Key words

Navigation