What is intermediate-risk neuroblastoma?

Neuroblastoma is a rare cancer that develops in very early nerve cells called neuroblasts. These cells form while a baby is growing in the womb and are part of the sympathetic nervous system. Most neuroblasts mature and disappear before birth. If some of these immature cells grow or divide in an uncontrolled way, they can form a tumour. 

The name comes from: 

• Neuro – nerve 
• Blast – immature cell 
• Oma – tumour 

Intermediate-risk neuroblastoma is a subset of the disease with specific features. It means the tumour has some features that make it more challenging to treat than low-risk, but it is not as aggressive as high-risk disease. Doctors use the International Neuroblastoma Risk Group (INRG) system to decide risk, looking at the tumour’s location, whether it has spread, the child’s age, and the tumour’s biology. 

How doctors decide if neuroblastoma is intermediate risk 

Doctors consider: 

• Where the tumour is and whether it has spread: Intermediate risk often means the tumour is localised but may have some imaging risk features (INRG “L2”) or has spread only to limited areas (INRG “MS” in infants). 

• Age at diagnosis: Children under 18 months with certain types of spread (MS stage) may be intermediate risk. 

• Tumour biology: Tumours without MYCN amplification and with more favourable features are more likely to be intermediate risk. 

• Imaging features (IDRFs): These show if the tumour is close to important structures. 

What intermediate risk means for treatment 

Children with intermediate-risk neuroblastoma may need a combination of treatments, but usually less intensive than for high-risk disease. Treatment may include: 

• Surgery to remove the tumour 
• Chemotherapy 

Your child’s team will explain the treatment plan and what it means for your family. 

Read more about treatment for intermediate-risk neuroblastoma.