Comparison of stage IV and IV-S neuroblastoma in the first year of life.

Clinical staging and factors related to survival were evaluated in 44 stage IV-S and 44 stage IV patients with neuroblastoma, ages 0 to 12 months, seen at Children's Cancer Study Group (CCSG) institutions from 1972 to 1979. In 73 patients with complete surgical staging, the life-table projected survival at 3 years was 91% for stage IV-S and 44% for stage IV. The only deaths in stage IV-S disease occurred in three patients less than 2 months old at diagnosis. In stage IV-S, 3 to 12 months old at diagnosis, the disease-free survival was 97%. Chemotherapy or radiation therapy did not appear to improve the survival rate in stage IV-S. These studies further document a significant clinical and biologic difference between patients with stage IV and stage IV-S neuroblastoma and suggest that they require different therapeutic management.