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Introduction

This is the data sheet for TNM 8th edition staging of neuroblastoma


International neuroblastoma risk group

Stage

Description

L1

Localised tumour not involving vital structures as defined by the list of image-defined risk factors and confined to one body compartment

L2

Locoregional tumour with presence of one or more image-defined risk factors

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

Image-defined risk factors (IDRFS) in neuroblastic tumours

Ipsilateral tumour extension within two body compartments

Neck-chest, chest-abdomen, abdomen-pelvis

Neck

Tumour encasing carotid and/or vertebral artery and/or internal jugular vein

Tumour extending to base of skull

Tumour compressing the trachea

Cervico-thoracic junction

Tumour encasing brachial plexus roots

Tumour encasing subclavian vessels and/or vertebral and/or carotid artery

 Tumour compressing the trachea

Thorax

Tumour encasing the aorta and/or major branches

Tumour compressing the trachea and/or principal bronchi

Lower mediastinal tumour, infiltrating the costo-vertebral junction between T9 and T12

Thoraco-abdominal

Tumour encasing the aorta and/or vena cava

Abdomen/pelvis

Tumour infiltrating the porta hepatis and/or the hepatoduodenal ligament

Tumour encasing branches of the superior mesenteric artery at the mesenteric root

Tumour encasing the origin of the coeliac axis, and/or of the superior mesenteric artery

Tumour invading one or both renal pedicles

Tumour encasing the aorta and/or vena cava

Tumour encasing the iliac vessels

Pelvic tumour crossing the sciatic notch

Intraspinal tumour 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, duodeno-pancreatic block, and mesentery

Conditions to be recorded, but not considered IDRFs

Multifocal primary tumours

Pleural effusion, with or without malignant cells

Ascites, with or without malignant cells


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Last edited: 14 June 2023 2:12 pm

  1. Cancer staging guidance sheets
  2. Lip and oral cavity (ICD10 C00, C02-C06)
  3. Malignant melanoma of upper aerodigestive tract (ICD10 C00-06, C10-14, C30-32)
  4. Pharynx (ICD10 C01, C05.1-2, C09, C10.0, C10.2-3, C11-13)
  5. Major salivary glands (ICD10 C07, C08)
  6. Oesophagus including oesophagastric junction (ICD10 C15 & C16.0)
  7. Stomach (ICD10 C16 except C16.0)
  8. Small intestine (ICD10 C17)
  9. Appendix (ICD10 C18.1)
  10. Colon and rectum (ICD10 C18-C20)
  11. Anal canal and perianal skin data (ICD10 C21, C44.5)
  12. Liver (ICD10 C22.0)
  13. Intrahepatic bile ducts (ICD10 C22.1)
  14. Gallbladder (ICD10 C23, C24.0)
  15. Distal extrahepatic bile duct (ICD10 C24.0)
  16. Perihilar bile ducts (ICD10 C24.0)
  17. Ampulla of vater (ICD10 C24.1)
  18. Pancreas (ICD10 C25)
  19. Nasal cavity and paranasal sinuses (ICD10 C30.0, C31.0, C31.1)
  20. Larynx (ICD10 C32.0 C32.1, C32.2, C10.1)
  21. Lung (ICD10 C34)
  22. Thymic tumours (ICD10 C37)
  23. Soft tissues (ICD10 C38.1-2, C47-C49)
  24. Bone (ICD10 C40 & C41)
  25. Malignant melanoma of skin (ICD10 C43, C51.0, C60.9, C63.2)
  26. Merkel cell carcinoma of skin (ICD10 C44 & C63.2)
  27. Skin carcinoma of the head and neck (ICD10 C44.0, C44.2-4)
  28. Carcinoma of skin of the eyelid (ICD10 C44.1)
  29. Carcinoma of skin (excluding eyelid, head and neck, perianal, vulva and penis) (ICD10 C44.5-7, C63.2)
  30. Pleural mesothelioma (ICD10 C45)
  31. Breast tumours (ICD10 C50)
  32. Vulva (ICD10 C51)
  33. Cervix uteri (ICD10 C53)
  34. Uterine sarcomas
  35. Uterus - endometrium (ICD10 C54.1, C55)
  36. Ovarian, fallopian tube and primary peritoneal carcinoma (ICD10 C56, C57, C48.1, C48.2)
  37. Gestational trophoblastic neoplasms (ICD10 C58)
  38. Penis tumours (ICD10 C60)
  39. Prostate tumours (ICD10 C61)
  40. Testis tumours (ICD10 C62)
  41. Kidney tumours (ICD10 C64)
  42. Renal pelvis and ureter tumours (ICD10 C65 & C66)
  43. Urinary bladder tumours (ICD10 C67)
  44. Urethra tumours (ICD10 C68.0)
  45. Carcinoma of conjuctiva (ICD10 C69.0)
  46. Malignant melanoma of conjuctiva (ICD10 C69.0)
  47. Retinoblastoma (ICD10 C69.2)
  48. Malignant melanoma of uvea (ICD10 C69.3, C69.4)
  49. Carcinoma of lacrimal gland (ICD10 C69.5)
  50. Sarcoma of orbit (ICD10 C69.6)
  51. Thyroid gland (ICD10 C73)
  52. Adrenal cortex (ICD10 C74.0)
  53. Chronic lymphocytic leukaemia
  54. Hepatoblastoma (CTYA)
  55. Hodgkins and non-hodgkins lymphoma (ICD10 C81-88)
  56. Medulloblastoma
  57. Multiple myeloma
  58. Neuroblastoma
  59. Neuroendocrine tumours of the foregut
  60. Neuroendocrine tumours of the midgut and hindgut
  61. Non-hodgkin lymphoma (children)
  62. Rhabdomyosarcoma and other soft tissue sarcomas (CTYA)
  63. Wilms tumour of the kidney