International Neuroblastoma Staging System Committee (INSS) system

This staging system takes into consideration the results of surgery to remove the tumor. If using this system, the doctors cannot determine the stage of the cancer if the patient have not start any treatment and if the patients do not need or cannot have surgery as treatment.

  • Stage 1 – the tumour is still in one area of the body; it hasn’t spread to nearby lymph nodes; and all visible tumour has been completely removed by surgery (however the edges of the removed tumour may show some cancer cells, when looked under the microscope)
  • Stage 2 
    • 2A –  the tumour is still in the area where it started and only in one side of the body (Left or Right); the cancer has not spread to any nearby lymph nodes; however not all visible tumour could be removed by surgery (because of its size or position)
    • 2B – the tumour is still  only in one side of the body and may our may not have been removed completley by surgery; however it has spread to nearby lymph nodes (on the same side).
  • Stage 3 –  the tumour cannot be completely removed by surgery; and it has not spread to distant parts of the body; however it has spread  to both sides of body (spread to both sides of spine or to regional lymph nodes in the other side of the body).
  • Stage 4  – the tumour has spread to other parts of the body from where it started, such as distant lymph nodes, bones, bone marrow, liver, skin, and/or other organs, (but the child does not meet the criteria for stage 4S)
  • Stage 4S  (also called “special neuroblastoma“) – when the child is younger than one year of age. The tumour is located where it started; it may have spread to lymph nodes on the same side of body and also to the skin, liver and/or bone marrow, but not to the bones.  The spread to bone marrow is less than 10% of cells, and there is a better outlook for this stage than others.



Author: Sofia Gonçalves

...dreaming about creativity :)

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