In these patients, cooperative group and single institution studies have associated adverse outcome with older age at presentation (≥14 years [114, 118] or ≥18 years [106]), large tumor volume [119], poor response to induction therapy [120], axial location [114, 120], elevated LDH [121], secondary genetic abnormalities [122], deletion of p16 [123], and mutation of P53 [89, 90]. The gene discussed is TP53; the disease is neoplasm.