Metastatic neuroblastoma in infancy: What does the pattern of metastases contribute to prognosis?

Background. The purpose was to investigate the influence of metastatic patt ern and primary extension over midline on prognosis of infants with metasta tic neuroblastoma. Procedure. Data of 317 consecutive infants with metastat ic neuroblastoma were analyzed. Results. The amount of bone marrow infiltra tion (<10% vs. >10%) proved to be the most important factor and was more im portant than the presence of bone metastases. A disadvantage in outcome for patients with distant lymph node, intracranial, or atypical metastases or for patients with primary extension over midline could not be demonstrated. However, in the subgroup of patients treated with limited treatment, prima ry extension over midline proved a risk factor. Conclusion. A redefinition of Stage 4S on an international basis is suggested. (C) 2000 Wiley-Liss, In c.