The 5-year survival rate for neuroblastoma depends on a child’s risk group. Doctors use risk groups to determine how likely a child with neuroblastoma can be cured and what their treatment should be.

Neuroblastoma develops in immature nerve cells of the sympathetic nervous system. It’s the most common cancer in infants.

Each year there are about 700 to 800 cases in the United States. The average age of diagnosis is 17 months, and about 90% of cases are in children under 5 years. It makes up about 15% of childhood cancer deaths.

The most common place for neuroblastoma to develop is the adrenal glands, which are located on top of your kidneys. Most children with neuroblastoma have a good outlook, but children classified as high risk have about a 50% chance of surviving at least 5 years.

Keep reading to learn more about the risk groups and survival rates for children with neuroblastoma.

The survival rate of neuroblastoma depends on your child’s risk group. Their risk group is determined by factors, such as:

  • their age
  • how far the cancer has spread
  • how the tumor looks under a microscope
  • presence of certain genes

According to the American Cancer Society (ACS), the 5-year survival rate based on the Children’s Oncology Group (COG) risk groups are as follows:

Risk group5-year survival rate
Low risk95%
Intermediate riskaround 90% to 95%
High riskaround 50%

The National Cancer Institute (NCI) lists the overall 5-year survival rate for children under 15 years as 68%. The chances of survival tend to be higher with younger age. The 5-year survival rate for children younger than 1 year is 95%.

It was traditionally accepted that being under 12 months of age was associated with a better outlook, but some recent studies suggest that being under 18 months may be a more relevant predictor of outcome.

In a 2022 study, researchers found evidence that children older than 18 months have a higher chance of relapse than younger infants.

Neuroblastoma in adults is extremely rare with an estimated incidence of 1 in 10 million people. The outlook is significantly poorer in adults than in children.

What is a 5-year survival rate?

Health professionals often use a 5-year survival rate as a measure of a disease’s outlook. It refers to the percentage of people with the disease who live at least 5 years after the diagnosis.

A 5-year relative survival rate is another commonly used term. This is a measure of how many people with the disease are alive 5 years later compared with people without the disease.

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Doctors use risk groups to figure out how likely a child with neuroblastoma can be cured and how intensive their treatment should be.

The COG is the major childhood cancer group in the United States. Their system of determining risk group was originally based on the International Neuroblastoma Staging System (INSS).

In 2021, they adopted the International Neuroblastoma Risk Group Staging System (INRGSS). Future clinical trials will use this system to determine eligibility.

Here’s a comparison of the two staging systems:

INSS stageDescription
Stage 1The tumor can be completely removed surgically. Removed lymph nodes may also contain cancer.
Stage 2AThe tumor hasn’t spread to other areas but can’t be removed completely with surgery. Nearby lymph nodes aren’t cancerous.
Stage 2BIt’s the same as 2A, but nearby lymph nodes contain cancer.
Stage 3The tumor can’t be removed with surgery and has spread to nearby lymph nodes or other nearby areas.
Stage 4The tumor has spread to distant lymph nodes, bone, bone marrow, liver, skin, and/or other organs except for those in stage 4S
Stage 4SThe tumor has only spread to skin, liver, and/or bone marrow in an infant under 1 year. The spread to bone marrow is minimal.
INRGSS stageDescription
Stage L1The tumor hasn’t spread beyond its original site and no image-defined risk factors are found on imaging, such as CT scans or MRI.
Stage L2It’s the same as stage L1, but image-defined risk factors are found on imaging.
Stage MThe tumor has spread to other body parts except those in stage MS.
Stage MSThe tumor has spread to skin, liver, and/or bone marrow in an infant under 18 months.

Until recently, the COG used the following factors to determine risk group:

  • stage of the disease using INSS
  • age at time of diagnosis
  • presence of a genetic mutation called MYCN amplification
  • tumor ploidy, whether cancer cells have extra chromosomes
  • factors related to the appearance of cells under a microscope

Moving forward, they’ll use the following:

  • stage of disease using INRGSS
  • age at time of diagnosis
  • grade, how well the tumor cells are differentiated under a microscope
  • other factors related to the appearance of cells under a microscope
  • presence of genetic mutation called MYCN amplification
  • presence of chromosome 11q deletion
  • tumor ploidy, whether cancer cells have extra chromosomes

Like with many other cancers, early treatment gives you the best chance of a good outcome.

The vast majority of neuroblastomas arise in children with no family history, but about 1% to 2% of cases do run in families. There are no standard screening tests used to test for neuroblastoma. Sometimes a urine test is used to check for neuroblastoma when a child is 6 months old.

About 1% to 2% of people with neuroblastoma have a family history of the disease. On average, these children are younger (9 months at diagnosis) than people without a family history. About 20% of these patients have multifocal primary neuroblastoma.

According to the NCI, studies have found that screening for neuroblastomas may not help a child live longer. In addition, there’s no standard screening test for neuroblastoma. Nearly all neuroblastomas found with a urine test have a good outlook.

Many neuroblastomas have spread to distant body parts by the time they’re diagnosed. Early symptoms can vary from symptomless mass to major illness. Some common symptoms include:

  • lump in your child’s belly that doesn’t cause signs of pain
  • swelling in legs, upper chest, face, or neck
  • problems swallowing or breathing
  • unexplained weight loss
  • early fullness or not eating

It’s important to visit your child’s doctor as soon as possible if you suspect they may have neuroblastoma.

Learn more about the symptoms of neuroblastoma.

Is neuroblastoma curable?

Low or intermediate risk neuroblastoma is usually curable. High risk neuroblastoma may be hard to cure but is still often curable.

Can a child survive stage 4 neuroblastoma?

In a 2017 study, researchers found that the 10-year survival rate of children older than 18 months in Germany with stage 4 neuroblastoma increased from 2% to 38% from 1979 to 2015.

Can an infant survive stage 4S neuroblastoma?

Infants with stage 4S neuroblastoma commonly experience spontaneous regression. In a 2019 study, researchers found that stage 4S was curable about 90% of the time.

How often does neuroblastoma return after remission?

About 50% to 60% of people with high risk neuroblastoma have a recurrence, which is associated with a poor outlook. Most relapses happen within the first 2 years.

Brain cancer has surpassed leukemia as the top cause of cancer death in children. Leukemia death rates have improved, but brain and nervous cancer survival rates have remained relatively constant over the past 20 years.

Neuroblastoma survival rates vary depending on risk group. Children in low and intermediate risk groups survive at least 5 years over 90% of the time. High risk children survive 5 years about half the time.

It’s likely that survival rates will continue to improve over time as treatment improves. It’s important to visit your child’s doctor as soon as possible if you think your child has neuroblastoma so that treatment can be started early.