Stage | Description |
L1 | Localized tumor not involving vital structures as defined by the list of IDRFs (below) and confined to one body compartment |
L2 | Locoregional tumor with presence of one or more IDRFs |
M | Distant metastatic disease (except stage MS) |
MS | Metastatic disease in children younger than 18 months with metastases confined to skin, liver, and/or bone marrow |
IDRFs in neuroblastic tumors |
Ipsilateral tumor extension within two body compartments |
- Neck-chest, chest-abdomen, abdomen-pelvis
|
Neck |
- Tumor encasing carotid and/or vertebral artery and/or internal jugular vein
|
- Tumor extending to base of skull
|
- Tumor compressing the trachea
|
Cervicothoracic junction |
- Tumor encasing brachial plexus roots
|
- Tumor encasing subclavian vessels and/or vertebral and/or carotid artery
|
- Tumor compressing the trachea
|
Thorax |
- Tumor encasing the aorta and/or major branches
|
- Tumor compressing the trachea and/or principal bronchi
|
- Lower mediastinal tumor, infiltrating the costovertebral junction between T9 and T12
|
Thoraco-abdominal |
- Tumor encasing the aorta and/or vena cava
|
Abdomen/pelvis |
- Tumor infiltrating the porta hepatis and/or the hepatoduodenal ligament
|
- Tumor encasing branches of the superior mesenteric artery at the mesenteric root
|
- Tumor encasing the origin of the coeliac axis, and/or of the superior mesenteric artery
|
- Tumor invading one or both renal pedicles
|
- Tumor encasing the aorta and/or vena cava
|
- Tumor encasing the iliac vessels
|
- Pelvic tumor crossing the sciatic notch
|
Intraspinal tumor extension whatever the location provided that: |
- More than one third of the spinal canal in the axial plane is invaded and/or the perimedullary leptomeningeal spaces are not visible and/or the spinal cord signal is abnormal
|
Infiltration of adjacent organs/structures |
- Pericardium, diaphragm, kidney, liver, duodenopancreatic block, and mesentery
|
Conditions to be recorded, but not considered IDRFs |
- Multifocal primary tumors
|
- Pleural effusion, with or without malignant cells
|
- Ascites, with or without malignant cells
|