Predicting the prognosis of Wilms tumor by peripheral blood cells: a real-world study of more than 30 years.

Ital J Pediatr

Department of Urology Children's Hospital of Chongqing Medical University. National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.

Published: November 2024

AI Article Synopsis

  • This study investigates prognostic factors for Wilms tumor (WT) using peripheral blood cell profiling, addressing a gap in evaluation methods despite effective treatment strategies.
  • It finds significant differences in blood cell counts between WT and non-WT children, with specific indices affecting overall survival (OS) and event-free survival (EFS).
  • Key independent prognostic factors identified include lower M levels and stage IV disease, which were validated through statistical analysis and a nomogram, indicating their potential as predictive markers for WT outcomes.

Article Abstract

Background: Despite established excellent treatment strategies for Wilms tumor (WT), effective prognostic evaluation methods were lacking. This study aims to examine prognostic factors for WT through real-world peripheral blood cell profiling.

Methods: Basic data and pre-treatment laboratory indices from WT and non-WT children underwent Wilcoxon test analysis. Chi-square tests assessed the correlation between blood cells and the overall survival (OS) and event-free survival (EFS) of WT. Further the Log-rank test and multivariate Cox were used to identify independent prognostic factors for OS. Traditional accepted factors were included in multi-Cox and the nomogram was constructed to further validate the outcome.

Results: Blood cells significantly differed between WT and non-WT groups (P < 0.05). Univariate analysis revealed that NLR above 1.380, stage IV, M below 0.325 × 10/μL were linked with lower OS, and PLR below 94.632, LB above 3.570 × 10/μL, stage IV, M above 0.325 × 10/μL,age ≤ 3 years were meaningful for higher EFS (P < 0.05). While in the multifactorial COX, only M (HR:0.220, HR95%CI: 0.080 ~ 0.620, P = 0.004 and HR: 0.437, HR95%CI: 0.202 ~ 0.947, P = 0.036, respectively) and stage IV (HR: 7.890, HR95%CI: 1.650 ~ 37.770, P = 0.010 and HR: 3.720, HR95%CI: 1.330 ~ 10.408, P = 0.012, respectively) were independent prognostic factors for OS and EFS. These two variables also were significant after including recognized risk factors, and were demonstrated the predictability via nomogram.

Conclusions: OS and EFS were poorer in WT children with M below 0.325 × 10/μL, suggesting the potential as a prognostic predictor for WT.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566747PMC
http://dx.doi.org/10.1186/s13052-024-01805-8DOI Listing

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