[Neuroblastoma: update on clinical aspects and therapy]

Area of Science:

• Pediatric Oncology
• Developmental Biology
• Genetics

Background:

• Neuroblastoma remains a significant challenge in pediatric oncology despite extensive research.
• It is now understood to comprise at least two distinct entities with different prognoses.
• Exceptions to expected clinical courses occur in both favorable and unfavorable neuroblastoma types.

Purpose of the Study:

• To review the clinical features and peculiar patterns of neuroblastoma.
• To highlight the role of molecular biology and genomic alterations in predicting outcomes.
• To describe the International Neuroblastoma Staging System (INSS) criteria and treatment outlines.

Main Methods:

• Review of clinical and biological information on neuroblastoma.
• Focus on genomic alterations and their predictive value.
• Description of the International Neuroblastoma Staging System (INSS) criteria.
• Outline of treatment strategies for different clinical presentations.

Main Results:

• Neuroblastoma classification into favorable (localized disease, infants, stage IV-S) and unfavorable (older than one year, disseminated disease) entities.
• Identification of genomic alterations as potential predictors of unfavorable events.
• Establishment of INSS criteria for diagnosis, staging, and response evaluation.
• Description of tailored treatment approaches for various neuroblastoma presentations.

Conclusions:

• Neuroblastoma is not a single entity; distinct forms require different management.
• Biologic and genomic features are essential for accurate patient evaluation and prognosis.
• The INSS provides a standardized framework for international cooperation and improved understanding.
• Personalized treatment strategies based on clinical and molecular data are crucial for optimizing outcomes.