Instances of lung or liver metastases, major tumor spillage during resection, remote lymph node involvement, and bilateral tumors have worse outcomes. Survival is dependent on the tumor site and pretreatment clinical group. Orbit, paratesticular, vulvar, and vaginal tumors have a good prognosis, but other genitourinary tumors, extremity and trunk lesions, and parameningeal head and neck tumors have a worse prognosis. Resectability, lymph node involvement, DNA ploidy, and pretreatment TNM staging affect outcomes. Neuroblastoma is an embryonal tumor with bizarre behavior and can regress, mature, or rapidly progress.
Most patients have advanced disease at diagnosis.
Neuroblastoma is associated with loss of heterozygosity on chromosome 1p36 and occasionally deletions on 14q and 17q. Newer protocols individualize treatment using risk factors as predictors of outcomes.