Teng Huaida, Hou Boren, Shi Kui, Li Hang, Wang Jiarong, Shi Junlei, Meng Deguang
Department of Surgical Oncology, Baoding Branch of Beijing Children's Hospital, Baoding Children's Hospital, Baoding, Hebei 071000, P.R. China.
Oncol Lett. 2025 Sep 1;30(5):506. doi: 10.3892/ol.2025.15252. eCollection 2025 Nov.
Wilms tumor (WT) is a common pediatric renal malignancy that poses significant challenges in clinical management and prognosis. The aim of the present study was to identify prognostic factors affecting outcomes in pediatric patients with WT following radical nephrectomy, to stratify high-risk groups for recurrence, and to develop a predictive model to support clinical decision-making and research in Chinese pediatric WT populations. The present retrospective, single-center study included clinical data from 180 pediatric patients with WT who underwent radical nephrectomy at the Baoding Branch of Beijing Children's Hospital (Baoding, China) between January 2015 and January 2019. Univariate and multivariate analyses were performed to identify prognostic factors, and a prediction model was constructed and validated. Progression-free survival (PFS) and overall survival (OS) were analyzed for all patients. The final follow-up was in July 2024. The results demonstrated that the 5-year OS and PFS rates were 99.6 and 94.3%, respectively. The median OS was 76.9 months (range, 30-101 months) and the median PFS was 75.5 months (range, 29-101 months). During follow-up, 25 patients experienced recurrence and 16 died. Univariate analysis revealed that clinical stage, histological subtype and tumor thrombus were significantly associated with prognosis (P<0.05). Multivariate Cox regression analysis identified advanced clinical stage [stage III-IV; hazard ratio (HR), 4.151; 95% confidence interval (CI), 1.440-11.922; P=0.009] and unfavorable histology (HR, 3.842; 95% CI, 1.592-9.283; P=0.002) as independent prognostic factors. A predictive model incorporating these two variables was established, yielding an area under the receiver operating characteristic curve of 0.755 (95% CI, 0.685-0.816; P<0.001). In conclusion, clinical stage and histological subtype are independent predictors of prognosis in children with WT after radical surgery. A predictive model based on these factors may help estimate individual prognosis and guide clinical management strategies.
肾母细胞瘤（WT）是一种常见的儿科肾脏恶性肿瘤，在临床管理和预后方面带来了重大挑战。本研究的目的是确定影响小儿WT患者根治性肾切除术后预后的因素，对复发高危组进行分层，并建立一个预测模型，以支持中国儿科WT人群的临床决策和研究。本项回顾性单中心研究纳入了2015年1月至2019年1月期间在北京儿童医院保定分院（中国保定）接受根治性肾切除术的180例小儿WT患者的临床数据。进行单因素和多因素分析以确定预后因素，并构建和验证预测模型。对所有患者分析无进展生存期（PFS）和总生存期（OS）。最后一次随访时间为2024年7月。结果显示，5年总生存率和无进展生存率分别为99.6%和94.3%。中位总生存期为76.9个月（范围30 - 101个月），中位无进展生存期为75.5个月（范围29 - 101个月）。随访期间，25例患者复发，16例死亡。单因素分析显示，临床分期、组织学亚型和肿瘤血栓与预后显著相关（P<0.05）。多因素Cox回归分析确定晚期临床分期[III - IV期；风险比（HR），4.151；95%置信区间（CI），1.440 - 11.922；P = 0.009]和不良组织学（HR，3.842；95% CI，1.592 - 9.283；P = 0.002）为独立预后因素。建立了包含这两个变量的预测模型，受试者工作特征曲线下面积为0.755（95% CI，0.685 - 0.816；P<0.001）。总之，临床分期和组织学亚型是小儿WT根治性手术后预后的独立预测因素。基于这些因素的预测模型可能有助于估计个体预后并指导临床管理策略。
