International Neuroblastoma Pathology Prognostic Classification (INPC)
Shimada Classification, Unfavorable histology or Favorable histology
Description
The International Neuroblastoma Pathology Prognostic Classification (INPC) categorizes neuroblastomas as favorable or unfavorable histologies based on the following factors: age, neuroblastic maturation, Schwannian stromal content, Mitosis-kayorrhexis index (MKI), and degree of differentiation (grade).
The International Neuroblastoma Pathology Prognostic Classification (INPC) (unfavorable versus favorable histology) is a biologically relevant classification based on morphologic features of neuroblastic tumors which has prognostic indications. It is based on the following criteria.
* Age
* Neuroblastic maturation
* Schwannian stromal content
* Mitosis-kayorrhexis index (MKI)
* Degree of differentiation (grade)
Rationale
This is part of the National Childhood Cancer Registry (NCCR) project to collect more specific information on pediatric patients. Registries part of the NCCR will start collection on specific pediatric data items with 2024+ diagnoses.
Additional Info
**Source documents:** pathology report
For further information, refer to the **Neuroblastoma** cancer protocol published by the College of American Pathologists.
Notes
**Note 1:** **Effective years**
* This SSDI is effective for diagnosis years 2024+
* For cases diagnosed 2018-2023, this SSDI must be blank
**Note 2:** **Physician statement**
* Physician statement of unfavorable vs favorable histology can be used to code this data item when no other information is available, provided there is information that the results are from a biopsy or surgical resection without neoadjuvant therapy.
**Note 3:** **Neoadjuvant Therapy**
* The INPC results are to be coded based on either biopsy or surgical resection (without neoadjuvant therapy).
* **Code 9** if the only results are from a post neoadjuvant surgical resection
Metadata
SSDI
| Code |
Description |
| 0 |
Unfavorable |
| 1 |
Favorable |
| 7 |
Test ordered, results not in chart |
| 8 |
Not applicable: Information not collected for this case
(If this information is required by your standard setter, use of code 8 may result in an edit error) |
| 9 |
Not documented in medical record
Cannot be determined by pathologist
International Neuroblastoma Pathology Prognostic Classification (INPC) not assessed or unknown if assessed
INPC assessed only at post neoadjuvant surgical resection |
| <BLANK> |
N/A - Diagnosis year is prior to 2024 |
(1) American Society of Clinical Oncology © 2009, The International Neuroblastoma Risk Group (INRG) Classification System: AN INRG Task Force Report; published by American Society of Clinical Oncology, 2009
