Staging
International Neuroblastoma Staging System
The International Neuroblastoma Staging System classifies neuroblastoma using the extent of disease and findings from surgery and lymph-node assessment.
Also called: INSS
Stages
- 1
Localized, completely excised
Localized tumor completely removed, with negative regional lymph nodes.
- 2A
Localized, incompletely excised
Localized tumor with incomplete gross excision and microscopically negative ipsilateral nonadherent nodes.
- 2B
Localized with positive ipsilateral nodes
Localized tumor with positive ipsilateral nonadherent nodes and negative contralateral nodes.
- 3
Unresectable or midline-crossing
Unresectable unilateral tumor crossing the midline, specified contralateral nodal spread, or midline tumor with bilateral extension.
- 4
Distant metastatic disease
Distant dissemination, including to distant nodes, bone, marrow, liver, skin or other organs.
- 4S
Special infant metastatic category
Localized primary tumor with spread limited to skin, liver or marrow in an infant younger than 1 year.
Judged onTumor extent, surgical resection and regional lymph-node findings
INSS describes neuroblastoma extent after surgery, so the operative findings contribute to the assigned stage. Its categories distinguish localized tumors with different resection and nodal findings from unresectable or disseminated disease. Stage 4S identifies a limited metastatic pattern in infants, which differs from widespread stage 4 disease.
Learn it in
- NeuroblastomaPediatrics