International neuroblastoma staging system stage 1 neuroblastoma: A prospective study and literature review Journal Article


Authors: Kushner, B. H.; Cheung, N. K. V.; LaQuaglia, M. P.; Ambros, P. F.; Ambros, I. M.; Bonilla, M. A.; Ladanyi, M.; Gerald, W. L.
Article Title: International neuroblastoma staging system stage 1 neuroblastoma: A prospective study and literature review
Abstract: Purpose: To gain insight into the management of non-metastatic neuroblastoma by examining clinical and biologic features of International Neuroblastoma Staging System (INSS) stage 1 tumors. Methods: Patients were staged by bath the INSS and the Evans staging system and were evaluated for biologic prognostic factors. Patients with INSS stage 1 received no cytotoxic therapy. The literature was reviewed for clinical and biologic data about INSS stage 1. Results: We evaluated 10 consecutive patients (median age, 17.5 months) with INSS stage 1; all remain disease-free (median follow-up duration, > 5 years). Tumors were in the abdomen (n = 6), chest (n = 3), or pelvis (n = 1), Neuroblastoma involved margins of resection in six tumors. Poor-prognostic biologic findings included tumor-cell diploidy (n = 2) and unfavorable Shimada histopathology (n = 2). Two patients were to receive chemotherapy for, respectively, a tumor deemed unresectable and a tumor classified as Evans stage III; second opinions resulted in surgical management alone in each case. Published reports confirm that some INSS stage 1 patients (1) are at risk for overtreatment, and (2) have poor-prognostic biologic findings yet do well. Conclusion: Surgery alone suffices for INSS stage 1 neuroblastoma, even if biologic prognostic factors are unfavorable, microscopic disease remains after surgery, and tumor size is suggestive of 'advanced-stage' status in other staging systems. Attempts to resect regionally confined neuroblastomas should take precedence over immediate use of cytotoxic therapy; otherwise, some patients may receive chemotherapy or radiotherapy unnecessarily.
Keywords: adolescent; adult; cancer chemotherapy; clinical article; child, preschool; middle aged; cancer surgery; review; cancer staging; antineoplastic agent; neoplasm staging; prospective study; prospective studies; biological marker; dacarbazine; cyclophosphamide; vincristine; infant; neuroblastoma; humans; prognosis; human; male; female; priority journal
Journal Title: Journal of Clinical Oncology
Volume: 14
Issue: 7
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1996-07-01
Start Page: 2174
End Page: 2180
Language: English
PUBMED: 8683252
PROVIDER: scopus
DOI: 10.1200/JCO.1996.14.7.2174
DOI/URL:
Notes: Review -- Export Date: 22 November 2017 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Brian Kushner
    190 Kushner
  2. Nai-Kong Cheung
    439 Cheung
  3. William L Gerald
    367 Gerald
  4. Marc Ladanyi
    862 Ladanyi