Residual nephrogenic rests affect the long-term prognosis of Wilms tumor with bilateral nephrogenic rests

The progression of nephrogenic rests (NRs) can lead to the development of Wilms tumor (WT). The aim is to explore the factors affecting the poor prognosis associated with WT combined with bilateral NRs.

We retrospectively analyzed the clinical data of patients with WT combined bilateral NRs admitted to our center from January 2008 to December 2022. The enrolled patients were divided into two groups according to whether they had residual NRs at the end of standard therapy or not.

57 patients were finally enrolled in this study, of which 23 patients were in the non-residual NRs group and 34 patients were in the residual NRs group. In the residual NRs group, 15 patients (44.1%) ultimately progressed to WT, and 3 patients died of tumor. In the non-residual NRs group, 1 patient (4.3%) experienced WT development (P < 0.01). The 5-year EFS of the non-residual group was 95.6%, which was significantly higher than that of the residual group (70.5%) (p < 0.01). Univariate and multivariate Cox analysis revealed that residual NRs was the risk factor for WT progression in the WT patients with bilateral NRs.

The residual NRs increased the risk of WT development and led to poor prognosis. Future multicenter prospective studies may need to further assess the conditions of patients with residual NRs to guide further treatment.