Treatment of localized neuroblastoma

The treatment of neuroblastoma must take into account the prognosis as determined at the time of diagnosis. The stage is an important prognostic factor. In Evans's Stage I neuroblastoma, surgery is curative in itself and adjuvant treatment is not needed. In Evans' Stage II, it is our opinion that the presence of involved lymph nodes worsens the prognosis. Therefore, we suggest that patients with Stage II should be divided into Stage IIA (without lymph node involvement) and Stage IIB (with lymph node involvement). The treatment of Stage IIA patients may be the same as for Stage I patients, i.e., surgery alone. However, Stage IIB patients should be treated with intensive combined chemotherapy of short duration following surgery.