Clinical Staging of Neuroblastoma in Children Proposed By the Children's Cancer Study Group A

Children with neuroblastoma may be clinically staged using the scheme proposed by the Children's Cancer Study Group A in 1971.

Stage	Description
I	• tumor confined to organ or structure of origin
II	• tumor extending in continuity beyond the organ or structure of origin without crossing midline • regional lymph nodes on the homolateral side may be involved
III	• tumors extending in continuity beyond the midline • bilateral involvement of regional lymph nodes
IV	• remote disease involving skeleton, organs, soft tissue • involvement of remote lymph nodes
IV-S	• criteria for stage I or II, AND • remote disease in one or more of the following: liver, skin or bone marrow (with no radiographic evidence of bone metastases on complete bone survey)

Staging workup (in 1971):

(1) X-rays of chest and skeleton, including skull and long bones

(2) intravenous pyelogram (excretory urogram)

(3) bone marrow examination

(4) determination of extent of primary disease

Additional studies that may be helpful

(1) inferior vena cavagram

(2) lymphangiogram

(3) urinary catecholamine excretion

(4) liver scan

(5) special roentgen views of the neural foramina

(6) myelogram

To read more or access our algorithms and calculators, please log in or register.