Clinical and biologic features in the prognosis and treatment of neuroblastoma

Recent advances in the management of neuroblastoma have their basis in an increasing understanding of the biologic diversity that typifies these tumors. Current therapy is defined by risk of disease progression or relapse and has become best delineated in lower-stage disease and in infants. Older children with disseminated disease continue to exhibit very poor overall outlook, despite recent advances in dose-intensive chemotherapy. This review updates the clinical and biologic features of neuroblastoma that have a significant impact on prognosis and therapeutic design and discusses recent trends and controversies in the treatment of specific subsets of patients.