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 |
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