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Lymph node ratio serves as a potential prognostic indicator for overall survival in Wilms tumorLymph node ratio may help predict survival for Wilms tumor

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Key Takeaway
Note that the role of lymph node ratio in Wilms tumor survival is currently not quantified by specific effect sizes.

This meta-analysis evaluates the clinical utility of the lymph node ratio (LNR) as a prognostic indicator for children diagnosed with Wilms tumor. The scope of the review focuses on primary outcomes of overall survival (OS) and secondary outcomes including 5-year, 10-year, and 20-year survival rates.

The synthesis of data regarding the impact of LNR on survival outcomes is currently incomplete, as specific effect sizes, p-values, and absolute numbers were not reported. The analysis aims to determine if LNR can serve as a reliable metric for predicting long-term outcomes in pediatric patients.

Due to the lack of reported statistical significance or specific quantitative results in the source, the clinical utility of LNR for individual patient management is not established by this meta-analysis. Further data are required to determine the strength of the association between LNR and survival outcomes in Wilms tumor patients.

How this fits prior evidence

This meta-analysis addresses a gap in prognostic markers for Wilms tumor by evaluating the lymph node ratio (LNR). It complements existing evidence regarding the management of rare variants, such as epithelial-type Wilms tumor in young adults, and the management of relapsed cases where 68% overall survival was reported. It also relates to the need for long-term monitoring, as evidenced by a case of recurrence 32 years after diagnosis.

When a child is diagnosed with Wilms tumor, a type of kidney cancer, every piece of information helps doctors plan the best path forward. One specific measurement is the lymph node ratio, which compares the number of involved lymph nodes to the total number of nodes sampled.

This analysis looked at how this ratio relates to overall survival for children with the condition. The study focused on whether this specific ratio could serve as a clearer indicator of how the disease progresses over time, including long-term survival markers at five, ten, and twenty years.

While the data provides a way to look at survival trends, the results are currently limited by the lack of specific outcome numbers in this analysis. Because the data is not yet fully detailed, it serves as a starting point for understanding how lymph node ratios might eventually help doctors predict outcomes for these young patients.

What this means for you:
The lymph node ratio is being studied as a way to predict survival for children with Wilms tumor.

Common questions

What is Wilms tumor?

Wilms tumor is a type of cancer that primarily affects the kidneys of children. Because it is a serious condition, doctors look for various markers, such as the lymph node ratio, to help understand how the disease might progress and how well a child might survive the treatment.

What is the lymph node ratio?

The lymph node ratio is a measurement that compares the number of lymph nodes affected by cancer to the total number of lymph nodes sampled. Doctors use this ratio to help determine the extent of the disease and to help predict long-term survival outcomes for patients.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
BackgroundLymph node (LN) involvement is a critical determinant of staging and prognosis in Wilms tumor (WT). However, conventional binary nodal staging (positive vs. negative) is often compromised by significant variability in surgical lymph node sampling. The lymph node ratio (LNR), which integrates metastatic burden and sampling adequacy, has emerged as a potential prognostic alternative. This systematic review and meta-analysis evaluated whether LNR serves as an independent predictor of survival outcomes in children with WT.MethodsA systematic query of PubMed, MEDLINE, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov was executed, covering the period from their earliest records through May 10, 2026. Retrospective cohort studies reporting hazard ratios (HRs) or risk ratios (RRs) for survival outcomes based on LNR in children with WT were included. Overall survival (OS) was the primary outcome; 5-year, 10-year, and 20-year OS were secondary outcomes. Prespecified subgroup analyses were performed by LNR cutoff (≥0.40 vs.
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