Subgrouping of Unfavorable Histology Neuroblastomas With Immunohistochemistry Toward Precision Prognosis and Therapy Stratification

Ikegaki N, Shimada H; International Neuroblastoma Pathology Committee. Subgrouping of Unfavorable Histology Neuroblastomas With Immunohistochemistry Toward Precision Prognosis and Therapy Stratification. JCO Precis Oncol. 2019;3:PO.18.00312. doi: 10.1200/PO.18.00312. Epub 2019 May 17. PMID: 31840131; PMCID: PMC6910237.

Neuroblastoma, as well defined by Willis,1 is an embryonal tumor of neural crest origin. Tumors of the neuroblastoma group include neuroblastoma, ganglioneuroblastoma, and ganglioneuroma. We believe that all ganglioneuromas were once neuroblastomas in the early stage of tumor development.1,2 They are collectively called peripheral neuroblastic tumors (pNTs) and are known to present with a wide range of clinical behavior, from spontaneous regression and tumor maturation to aggressive progression that is refractory to intensive treatment. Recent advances in research indicate that molecular and/or genomic properties of individual tumors are closely associated with their unique clinical behaviors.3-5 During the past several decades, histopathologic analyses of pNTs have provided invaluable information for predicting prognosis and determining therapy stratification. The origin of International Neuroblastoma Pathology Classification (INPC) dates to the 1984 article by Shimada et al6 that first introduced the age-linked pathology classification system. Since then, the Shimada system has laid the foundation for the current INPC.2,7 The INPC, as a single prognostic parameter, clearly defines clinically aggressive and nonaggressive groups of pNTs.7,8