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Intermediate-Risk Neuroblastoma
Source: Neuroblastoma Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 28, 2025 · Captured 2026-09-09.
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Context: Treatment of Non–High-Risk Neuroblastoma
According to the 2021 COG risk classifier, intermediate risk includes the following for localized, INRG stage L2 tumors (no MYCN amplification):[1]
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Children younger than 5 years with favorable biology.
Children older than 5 years with favorable biology and differentiating tumors (International Neuroblastoma Pathology Classification [INPC]).
Children younger than 365 days with unfavorable histology (UH), DNA Index (DI) higher than 1, no segmental chromosomal alterations (SCAs).
Children younger than 365 days with FH, DI is 1, no SCAs.
Children younger than 365 days with UH, DI is 1, no SCAs.
Children younger than 365 days with FH, DI higher than 1, and SCAs.
Children older than 365 days with FH and SCAs.
Children younger than 365 days with SCAs (with either UH or DI = 1).
Children aged 365 days to younger than 547 days with UH.
Stage M (no MYCN amplification):[1]
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Children younger than 365 days with all favorable biology.
Children younger than 365 days with 1 or more unfavorable biological features.
Children aged 365 days to younger than 547 days with FH, DI higher than 1, no SCAs.
Stage MS (no MYCN amplification):[1]
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Children younger than 3 months with evolving hepatomegaly or symptomatic with all favorable biology.
Symptomatic children with unfavorable biology.
Children aged 365 days to younger than 18 months, FH, and no SCAs (DI > 1).
For infants with stage MS tumors who are too unstable to undergo biopsy before starting treatment, chemotherapy is initiated, and a biopsy is obtained when safe.
For more information about the COG risk categories, see Table 3.
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For more information about stage 4S and MS tumors, see the Treatment of INSS Stage 4S and INRG Stage MS Neuroblastoma section.
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Preserved source evidence · Not medical advice