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Staging

International Neuroblastoma Risk Group Staging System

The 2009 INRG staging system assigns neuroblastoma stage before treatment using imaging-based risk factors and whether disease is localized or metastatic.

Also called: INRGSS

Stages

  1. L1

    Localized, no image-defined risk factors

    Locoregional tumor without any image-defined risk factor.

  2. L2

    Localized, with image-defined risk factors

    Locoregional tumor with at least one image-defined risk factor.

  3. M

    Metastatic

    Metastatic disease that does not meet the MS definition.

  4. MS

    Special metastatic category

    Metastases limited to skin, liver and/or bone marrow in a child younger than 18 months.

Judged onPretreatment imaging, image-defined risk factors and metastatic distribution

INRGSS was created for staging before treatment, unlike the postsurgical INSS system. It separates localized tumors according to the presence of image-defined risk factors, then distinguishes metastatic disease from a defined infant and toddler metastatic pattern. The pretreatment stage gives a common way to describe neuroblastoma extent across risk assessment and clinical studies.

Learn it in

Card id: inrgss

Sources

  • The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report, Monclair T et al., Journal of Clinical Oncology, 2009, https://doi.org/10.1200/JCO.2008.16.6876

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