Clinicopathological characteristics of ganglioneuroma and ganglioneuroblastoma: a report from the CCG and COG.
BACKGROUND
The International Neuroblastoma Pathology Classification (INPC) was the first to clearly define prognostic subgroups in ganglioneuroma (GN) and ganglioneuroblastoma (GNB).


METHODS
Histopathology and tumor resectability of 552 GN/GNB cases from the Children's Cancer Group (CCG) and Children's Oncology Group (COG) neuroblastoma studies were reviewed. The results were analyzed along with clinical information and biological data of the cases.


RESULTS
According to the INPC, 300 tumors were classified into the Favorable Histology (FH) group and 252 were into the Unfavorable Histology (UH) group. Tumors in the FH group included 43 ganglioneuroma-maturing (GN-M), 198 ganglioneuroblastoma-intermixed (GNB-I), and 59 ganglioneuroblastoma-nodular, favorable subset (GNB-N-FS), and were often (91%) resected completely by single or multiple surgical procedures. Patients with the FH tumors had an excellent prognosis with no tumor-related deaths. The UH group included ganglioneuroblastoma-nodular, unfavorable subset (GNB-N-US) tumors. Patients with the UH tumors had a high incidence (53%) of distant metastasis at the time of diagnosis, and their prognosis significantly depended on clinical stage (5-year EFS: 80.1% for non-stage 4 patients; 16.7% for stage 4 patients): Complete primary tumor resection was not beneficial to those GNB-N-US patients, regardless of whether metastasis was present or not. MYCN amplification was detected in four tumors in the FH group and six tumors in the UH group. The majority (160/191, 84%) of GN-M and GNB-I tumors had a diploid pattern determined by flow cytometry.


CONCLUSIONS
Stringent application of the INPC along with clinical staging was critical for prognostic evaluation of the patients with this group of tumors.
Okamatsu
Chizuko
C
Department of Pathology and Laboratory Medicine, Childrens Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California 90027, USA.
London
Wendy B
WB
Naranjo
Arlene
A
Hogarty
Michael D
MD
Gastier-Foster
Julie M
JM
Look
A Thomas
AT
LaQuaglia
Michael
M
Maris
John M
JM
Cohn
Susan L
SL
Matthay
Katherine K
KK
Seeger
Robert C
RC
Saji
Tsutomu
T
Shimada
Hiroyuki
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018305:Ganglioneuroblastoma / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D005729:Ganglioneuroma / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007223:Infant; D000071447:N-Myc Proto-Oncogene Protein; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000235:genetics; D015513:Oncogene Proteins / Q000235:genetics
C459801:MYCN protein, human; D000071447:N-Myc Proto-Oncogene Protein; D009687:Nuclear Proteins; D015513:Oncogene Proteins