Any new lesion; increase of any measurable lesion by >25% previous negative marrow has become positive for tumor.

Abbreviations: CR, complete response; VGPR, Very good partial response; PR, partial response; MR, mixed response; SD, stable disease; PD, progressive disease.

"Evaluation of primary and metastatic disease as outlined in Table 18-4.

bOne positive marrow aspirate or biopsy allowed for PR if this represents a decrease from the number of positive sites at diagnosis.

From Brodeur GM, Pritchard J, Berthold F, et al. Revisions of the International Criteria for Neuroblastoma Diagnosis, Staging, and Response to Treatment J Clin Oncol 1993;11:1466, with permission.

Stage 4. Remote disease involving the skeleton, bone marrow, soft tissue, and distant lymph node groups (see stage 4S).

Stage 4S. As defined in stage I or II, except for the presence of remote disease confined to the liver, skin, or bone marrow (without bone metastases).

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