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Updated: Jun 4, 2026

Murine Bilateral Renal Lymphadenectomy
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Murine Bilateral Renal Lymphadenectomy

Published on: December 30, 2025

Improved survival with lymph node sampling in Wilms tumor.

Ying Zhuge1, Michael C Cheung, Relin Yang

  • 1Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

The Journal of Surgical Research
|February 18, 2011
PubMed
Summary

Examining more lymph nodes in Wilms tumor (WT) patients improves survival rates. A higher number of examined lymph nodes is linked to better outcomes, while examining zero lymph nodes indicates a poorer prognosis.

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Area of Science:

  • Pediatric Oncology
  • Surgical Pathology
  • Cancer Epidemiology

Background:

  • Wilms tumor (WT) is a common pediatric kidney cancer.
  • Accurate staging is crucial for effective treatment and prognosis in WT.
  • Lymph node examination is a key component of pathological staging.

Purpose of the Study:

  • To investigate the association between the number of lymph nodes examined and survival outcomes in pediatric patients with Wilms tumor.
  • To determine if lymph node yield is an independent prognostic factor for Wilms tumor survival.

Main Methods:

  • Retrospective analysis of data from the Surveillance, Epidemiology, and End Results (SEER) and Florida Cancer Data System.
  • Inclusion criteria: patients under 20 years of age diagnosed with Wilms tumor.

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  • Statistical analysis including univariate and multivariate models to assess survival based on lymph node count.

    • Main Results:

    • A total of 1805 WT patients were analyzed; 1340 had available lymph node data.
    • Patients with 0 lymph nodes examined had significantly lower 5-year survival (87%) compared to those with 1-5 (91%), 6-10 (93%), and >10 (95%) nodes.
    • Multivariate analysis confirmed that examining 1-5, 6-10, or >10 lymph nodes was associated with a survival advantage compared to examining 0 lymph nodes.

    Conclusions:

    • Inadequate lymph node examination in Wilms tumor cases is associated with understaging and potentially suboptimal adjuvant therapy.
    • The number of lymph nodes examined is an independent prognostic indicator for survival in Wilms tumor patients.
    • Comprehensive lymph node evaluation is essential for accurate prognostication and improved patient outcomes in Wilms tumor.