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. 2009 Jan 10;27(2):298-303.
doi: 10.1200/JCO.2008.16.6876. Epub 2008 Dec 1.

The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report

Affiliations

The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report

Tom Monclair et al. J Clin Oncol. .

Abstract

Purpose: The International Neuroblastoma Risk Group (INRG) classification system was developed to establish a consensus approach for pretreatment risk stratification. Because the International Neuroblastoma Staging System (INSS) is a postsurgical staging system, a new clinical staging system was required for the INRG pretreatment risk classification system VSports手机版. .

Methods: To stage patients before any treatment, the INRG Task Force, consisting of neuroblastoma experts from Australia/New Zealand, China, Europe, Japan, and North America, developed a new INRG staging system (INRGSS) based on clinical criteria and image-defined risk factors (IDRFs). To investigate the impact of IDRFs on outcome, survival analyses were performed on 661 European patients with INSS stages 1, 2, or 3 disease for whom IDRFs were known V体育安卓版. .

Results: In the INGRSS, locoregional tumors are staged L1 or L2 based on the absence or presence of one or more of 20 IDRFs, respectively. Metastatic tumors are defined as stage M, except for stage MS, in which metastases are confined to the skin, liver, and/or bone marrow in children younger than 18 months of age. Within the 661-patient cohort, IDRFs were present (ie, stage L2) in 21% of patients with stage 1, 45% of patients with stage 2, and 94% of patients with stage 3 disease. Patients with INRGSS stage L2 disease had significantly lower 5-year event-free survival than those with INRGSS stage L1 disease (78% +/- 4% v 90% +/- 3%; P = . 0010) V体育ios版. .

Conclusion: Use of the new staging (INRGSS) and risk classification (INRG) of neuroblastoma will greatly facilitate the comparison of risk-based clinical trials conducted in different regions of the world. VSports最新版本.

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Figures

Fig 1.
Fig 1.
Event-free survival curves for International Society of Pediatric Oncology Europe Neuroblastoma Group patients by International Neuroblastoma Risk Group Staging System stage L1 versus L2 (P = .0010; n = 474). The number of patients at risk for an event are shown along the curves at years 2, 4, and 6.
Fig 2.
Fig 2.
Overall survival curves for International Society of Pediatric Oncology Europe Neuroblastoma Group patients by International Neuroblastoma Risk Group Staging System stage L1 versus L2 (P = .0068; n = 474). The number of patients at risk for death are shown along the curves at years 2, 4, and 6.

References

    1. Cohn SL, Pearson ADJ, London WB, et al: The International Neuroblastoma Risk Group (INRG) classification system: An INRG Task Force report. J Clin Oncol [epub ahead of print on December 1, 2008] - PMC - PubMed
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    1. Brodeur GM, Pritchard J, Berthold F, et al: Revisions of the international criteria for neuroblastoma diagnosis, staging and response to treatment. J Clin Oncol 11:1466-1477, 1993 - PubMed
    1. Kushner BH, LaQuaglia MP, Kramer K, et al: Radically different treatment recommendations for newly diagnosed neuroblastoma: Pitfalls in assessment of risk. J Pediatr Hematol Oncol 26:35-39, 2004 - PubMed
    1. Hero B, Simon T, Spitz R, et al: Localized infant neuroblastomas often show spontaneous regression: Results of the prospective trials NB95-S and NB97. J Clin Oncol 26:1504-1510, 2008 - PubMed

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