11q, 14q loss of Rare Common Rare heterozygosity (LOH) Age Usually <1 y Usually >1 y Usually 1 to 5 y Stage (INSS) 1, 2, 4S Usually 3 or 4 Usually 3 or 4 Stage (INRGSS) L1, MS L2 M Expected survival rate# Greater than 95% ~90% with various ~40% with surgery alone intensities of chemotherapy # on the experience of Children’s Oncology Group Neuroblastoma Studies/Protocols. Abbreviations: INSS, International Neuroblastoma Staging System; INRGSS, International Neuroblastoma Risk Group Staging System. Table 3. Risk Grouping Scheme Using the International Neuroblastoma Staging System (INSS) INSS Age MYCN Ploidy# INPC Other Low Risk 1 any any any any Low Risk 2a/2b any not amp any any resection >50% Intermediate Risk 2a/2b 0 12 y not amp any any resection <50% or biopsy only – High Risk 2a/2b any amp any any any degree of resection Intermediate Risk 3 <547 d not amp any any Intermediate Risk 3 >547 d 12 y not amp any FH – High Risk 3 any amp any any High Risk 3 d not amp any UH ≥547 High Risk 4 <365 d amp any any Intermediate Risk 4 <365 d not amp any any High Risk 4 365-<547 d amp any any High Risk 4 365-<547 d any DI=1 any High Risk 4 365-<547 d any any UH Intermediate Risk 4 365-<547 d not amp DI>1 FH High Risk 4 d any any any ≥547 Low Risk 4s <365 d not amp DI>1 FH asymptomatic Intermediate Risk 4s <365 d not amp any any symptomatic Intermediate Risk 4s <365 d not amp DI=1 any asymptomatic or symptomatic
11q, 14q loss of heterozygosity (LOH) Rare Common Rare Age Usually <1 y Usually >1 y Usually 1 to 5 y Stage (INSS) 1, 2, 4S Usually 3 or 4 Usually 3 or 4 Stage (INRGSS) L1, MS L2 M Expected survival rate# Greater than 95% with surgery alone ~90% with various intensities of chemotherapy ~40% # on the experience of Children’s Oncology Group Neuroblastoma Studies/Protocols. Abbreviations: INSS, International Neuroblastoma Staging System; INRGSS, International Neuroblastoma Risk Group Staging System. Table 3. Risk Grouping Scheme Using the International Neuroblastoma Staging System (INSS) INSS Age MYCN Ploidy# INPC Other Low Risk 1 any any any any Low Risk 2a/2b any not amp any any resection >50% Intermediate Risk 2a/2b 0 – 12 y not amp any any resection <50% or biopsy only High Risk 2a/2b any amp any any any degree of resection Intermediate Risk 3 <547 d not amp any any Intermediate Risk 3 >547 d – 12 y not amp any FH High Risk 3 any amp any any High Risk 3 ≥547 d not amp any UH High Risk 4 <365 d amp any any Intermediate Risk 4 <365 d not amp any any High Risk 4 365-<547 d amp any any High Risk 4 365-<547 d any DI=1 any High Risk 4 365-<547 d any any UH Intermediate Risk 4 365-<547 d not amp DI>1 FH High Risk 4 ≥547 d any any any Low Risk 4s <365 d not amp DI>1 FH asymptomatic Intermediate Risk 4s <365 d not amp any any symptomatic Intermediate Risk 4s <365 d not amp DI=1 any asymptomatic or symptomatic
cp-pediatric-neuroblastoma-16protocol-3103.docx