Table 13. Children’s Oncology Group (COG) Neuroblastoma High-Risk Group Assignment Schema

INSS Stage Age MYCN Status INPC Classification DNA Ploidya
2A/2Bb ≥365 d–21 y Amplified Unfavorable-
3c<365 dAmplifiedAnyAny
≥365 d–21 y Nonamplified Unfavorable-
≥365 d–21 y AmplifiedAny-
4c<365 dAmplifiedAnyAny
≥548 d–21 yAnyAny-
4S <365 dAmplifiedAnyAny

INPC = International Neuroblastoma Pathologic Classification; INSS = International Neuroblastoma Staging System.

aDNA Ploidy: DNA Index (DI) > 1 is favorable, DI = 1 is unfavorable; a hypodiploid tumor (with DI < 1) will be treated as a tumor with a DI > 1 (DI < 1 [hypodiploid] to be considered favorable ploidy).

bINSS stage 2A/2B symptomatic patients with spinal cord compression, neurologic deficits, or other symptoms are treated with immediate chemotherapy for four cycles.

cINSS stage 3 or stage 4 patients with clinical symptoms as listed above receive immediate chemotherapy.

From: Neuroblastoma Treatment (PDQ®)

Cover of PDQ Cancer Information Summaries
PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.

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