Japanese Journal of Clinical Oncology 21:1-7 (1991)
© 1991 Foundation for Promotion of Cancer Research
research-article |
Proposal and Assessment of Japanese Tumor Node Metastasis Postsurgical Histopathological Staging System for Neuroblastoma Based on an Analysis of 495 Cases
1Department of Pediatric Surgery, Faculty of Medicine, Kyushu University 1-1, Maidashi 3-chome, Higashi-ku, Fukuoka 812
2First Department of Surgery, Nihon University, School of Medicine 30-1, Oyaguchi Kamimachi, Itabashi-ku, Tokyo 173
3First Department of Surgery, Hokkaido University, School of Medicine Nishi 7-chome, Kita 15-jo, Kita-ku, Sappro 060
4Department of Pediatric Surgery, Tohoku University, School of Medicine 1-1, Seiryo-machi, Aoba-ku, Sendai 980
5Department of Pediatric Surgery, Niigata University, School of Medicine 754, Ichibancho, Asahimachi-dori, Niigata 951
6Department of Surgery, Gunma Children's Medical Center 779, Oaza Shimohakoda, Hokkitsmura, Seta-gun, Gunma 377
7First Department of Surgery, School of Medicine, Gunma University 39-15, Showamachi 3-chome, Maebashi 371
8Department of Pediatric Surgery, School of Medicine, Chiba University 8-1, lnohama 1-chome, Chiba 280
9Department of Pediatric Surgery, Faculty of Medicine, Tokyo University 3-1, Hongo 7-chome, Bunkyo-ku Tokyo 113
10Department of Pediatric Surgery, Juntendo University, Shool of Medicine 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo 113
11Department of Surgery, National Children's Hospital 35-31, Taishido 3-chome, Setagaya-ku, Tokyo 154
12Department of Surgery, School of Medicine, Keio University 35 Shinanomachi, Shinjuku-ku, Tokyo 160
13Department of Surgery, Kanagawa Children's Medical Center 138-4, Mutsukawa 2-chome, Minami-ku, Yoko hama 232
14First Department of Surgery, Hyogo College of Medicine 1-1, Mukogawa-cho, Nishinomiya 663
*For reprints and all correspondence
Received March 23, 1990; accepted September 17, 1990
In 1971, the Japanese Society of Pediatric Surgeons' Committee on Malignancies proposed new criteria for neuroblastoma staging. It was fundamentally, based on the system of Evans et al. described in 1971. The main difference was the separation of stage IV disease into stages IV-A, with metastases to bone, orbita, distant lymph nodes and viscera other than liver, IV-B, the primary tumor extending over the midline and with metastases to bone marrow, liver and skin, and IV-S, which was the same as that of Evans et al. The new criteria did not include the resectability of the primary tumor, assessment of regional lymph node involvement or any other disease assessment resulting from therapeutic intervention. For the purpose of international usage, the Japanese system has been newly formulated and proposed as the Japanese Tumor Node Metastasis (TNM) Postsurgical Histopathological Classification for Neuroblastoma. In the present report, 495 neuroblastomas, registered between 1970 and 1985, were analyzed retrospectively according to the International Union Against Cancer (UICC) TNM classification and the proposed Japanese TNM system. The analyses suggested that the Japanese system reflected both the extent of tumor invasion and its biological neuroblastoma characteristics better than the UICC TNM classification based on statistical analysis.
Key Words: Neuroblastoma • TNM classification • Japanese staging system