Prediction values of different lymph nodes staging systems for survival of children with Wilms tumor

Wilms tumor is one of the most common pediatric kidney cancers with poor prognosis. This study aims to explore the predictive values of lymph nodes (LNs), positive lymph node density (LND) and log odds of positive lymph nodes (LODDS) for the 5-year mortality of children with Wilms tumor.

The cohort study collected the data of 874 participants with Wilms tumor in the Surveillance, Epidemiology, and End Results (SEER) database. The univariate COX proportional risk model was used to explore the possible covariates. The univariate and multivariable COX proportional risk model were employed for exploring the correlations of LNs, LND, and LODDS with the 5-year mortality of Wilms tumor patients. The predictive values of LNs, LND, and LODDS for the 5-year mortality of children with Wilms tumor were evaluated via concordance and 95% confidence interval (CI).

The follow-up time was 5 years, and 804 participants survived in the end. The results delineated that LND >0 [hazard ratio (HR) =1.92, 95% CI: 1.01-3.67] as well as LND ≥0.93 (HR =4.87, 95% CI: 2.42-9.81) were correlated with increased risk of 5-year mortality while LODDS ≥-0.34 (HR =4.09, 95% CI: 2.18-7.65) was linked with elevated risk of 5-year mortality. The concordance of LNs for predicting the 5-year mortality of Wilms tumor patients was 0.623 (95% CI: 0.566-0.681). The concordances of LND, and LODDS for predicting the 5-year mortality of Wilms tumor patients were 0.623 (95% CI: 0.566-0.681) and 0.616 (95% CI: 0.562-0.669).

The predictive value of LODDS for the 5-year mortality of children with Wilms tumor was similar with LNs and LND. The findings might provide a new tool for helping the clinicians identify those with poor prognosis, and timely treatments should be offered to these patients.