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

Background/Objectives The progression of nephrogenic rests (NRs) can lead to the development of Wilms tumor (WT). To explore the factors affecting the poor prognosis associated with WT combined with bilateral NRs. Methods : 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. The overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier method, and prognostic risk factors were determined using univariate and multivariate cox analysis. Results : A total of 57 patients were finally enrolled in this study, of which 23 patients in the non-residual NRs group and 34 patients in the residual NRs group. In the residual NRs group, there were ultimately 15 patients (44.1%) experienced recurrence and 3 patients dead (recurrence of WT). In the non-residual NRs group, 1 patient (4.3%) experienced recurrence (P < 0.01). The difference of EFS between the two groups was significant (P<0.01). Univariate and multivariate cox analysis revealed that residual NRs was the risk factor of EFS within WT combined with bilateral NRs. Conclusion : The residual NRs increased the risk of recurrence and led the poor prognosis. Future multi-center prospective studies may need to further assess the conditions of patients with residual NRs to guide further treatment.