Treatment Risk Stratification for Neuroblastoma
| INSS stage | Age (y) | MYCN | Shimada histology | DNA index | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Low-risk (survival >90% with surgery alone) | ||||||||||||
| 1 | 0–21 | Any | Any | Any | ||||||||
| 2A/2B | 0–<1 | Any | Any | Any | ||||||||
| 2A/2B | 1–18 | NA | Any | Any | ||||||||
| 4S | 0–<1 | NA | Favorable | >1 | ||||||||
| Intermediate-risk (survival >90% with surgery, chemotherapy) | ||||||||||||
| Favorable Biology | ||||||||||||
| 3 | 0–21 | NA | Favorable | >1 | ||||||||
| 4 | 0–<1 | NA | Favorable | >1 | ||||||||
| Unfavorable Biology | ||||||||||||
| 3 | 0–<1 | NA | Unfavorable | or | 1 | |||||||
| 4 | 0–<1 | NA | Unfavorable | or | 1 | |||||||
| 4S | 0–<1 | NA | Unfavorable | or | 1 | |||||||
| High-risk (survival <30% with intensive multimodality therapy) | ||||||||||||
| 2A, 2B | 1–21 | A | and | Unfavorable | Any | |||||||
| 3 | 0–<1 | A | Any | Any | ||||||||
| 3 | 1–21 | A | or | Unfavorable | Any | |||||||
| 4, 4S | 0–<1 | A | Any | Any | ||||||||
| 4 | 1–21 | Any | Any | Any | ||||||||
A = amplified (>10 copies); NA = not amplified (≤10 copies).
Data are from (20).