MYCN and metastatic neoplasm: After the CCG study, COG completed COG A3973 using age, MYCN status, INSS stage, and INPC including patients under 12 months with MYCN amplified INSS stage 3, 4, or 4s disease, patients over 12 months with INSS stage 4 or stage 3 disease with MYCN amplification or unfavorable histology or stage 2 disease with unfavorable histology and MYCN amplification, as well as patients who originally had low stage disease that returned with metastatic disease to determine whether purging neuroblastoma cells from autologous stem cells improves outcomes [47].