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Staging

The tests used to diagnose neuroblastoma can also be used to determine the stage of the disease. Stage is a term that refers to the location and extent of cancer tumor(s) and cells. Neuroblastoma treatment can differ widely depending on the stage. The tumor stages outlined below are based on a tumor-staging system used by experts worldwide.

Stage 1

The tumor is confined to the area in which it arose (i.e., there has been no spread, or metastasis) and can be completely removed by surgery.

Stage 2A

The tumor is confined to the area in which it arose, but cannot be completely removed by surgery.

Stage 2B

The tumor is confined to the area in which it arose. It may or may not be possible to completely remove the tumor by surgery. Neuroblastoma cells are present in the lymph nodes adjacent to the tumor.

Stage 3

The tumor cannot be completely removed by surgery and has either:

  • spread from one side of the body to the other and may also have spread to nearby lymph nodes;
  • remained confined to the area in which it arose, but spread to lymph nodes on the other side of the body; or
  • remained confined to the middle of the body and spread to lymph nodes on both sides of the body.

Stage 4

The tumor has spread to distant lymph nodes, bone marrow, bone, liver, or other organs (except as defined by stage 4S).

Stage 4S

Stage 4S is applicable only to children who are younger than one year. The tumor is confined to the area in which it arose, as in stages 1 and 2, but some cells have spread to the liver, skin, or bone marrow.

What happens after a diagnosis?

We combine information about the stage of your child’s neuroblastoma with genetic information about the tumor and the type of neuroblastoma cells involved. This helps us determine if your child’s condition is low riskintermediate risk, or high risk, and then formulate a treatment plan.

  • Low-risk neuroblastoma usually involves infants and children who have very small tumors that can easily be removed through surgery.
  • Intermediate-risk disease is typically diagnosed in children who have larger tumors that haven’t spread to other parts of the body, or children younger than 18 months old whose tumors have spread.
  • High-risk neuroblastoma includes disease that has spread and is diagnosed after 18 months of age, as well as patients with tumors found to contain the genetic characteristic known as MYCN amplification (regardless of age or whether the disease has spread).