If a child is diagnosed with neuroblastoma, the risk group is also determined. This risk group is usually related to how far the tumor has spread and the risk of the neuroblastoma coming back. It also determines the treatment the child receives.
There are three risk groups:
- Low-risk neuroblastoma
- Intermediate risk neuroblastoma
- High risk neuroblastoma
Stages of neuroblastoma
As with all cancers, neuroblastoma can spread to other parts of the body. The most common areas are the liver, skin, and bones. There are different 'stages' of the disease that describe how far the tumor has grown and spread.
- Stage 1: Tumor is localized and has not spread. It can be almost completely removed by surgery.
- Stage 2: The tumor is localized and has not spread, but cannot be completely removed by surgery. This is often due to the position of the tumor, meaning that total removal of the tumor would cause damage to organs or major blood vessels.
- Stage 3: The tumor begins to spread to nearby lymph nodes, but not to distant parts of the body.
- Stage 4: The tumor has spread to distant parts of the body. Unfortunately, relapse in this group of patients is common.
- Stage 4s: This is a stage that is unique to this type of childhood cancer and does not occur in children older than 18 months. It refers to a type of disease that presents as a primary tumor and may have spread to local lymph nodes, but only on one side of the body. There will be no spread to the bones and less than 10% of the bone marrow cells will be neuroblastoma. This type of disease is known to revert spontaneously to a benign state and so the only course of treatment is by closely observing the child to make sure nothing changes.