ArticleFrontiers in oncology2026
Preoperative neutrophil-to-lymphocyte ratio as an early risk-stratification and prognostic biomarker in Wilms tumor: a retrospective study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the predictive value of the preoperative neutrophil-to-lymphocyte ratio (NLR) for prognosis in patients with Wilms tumor (WT). Methods: A retrospective study was conducted involving 178 children with WTwho underwent surgery. The preoperative NLR was calculated from routine blood tests. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive performance of NLR for overall survival (OS) and event-free survival (EFS). The association between NLR and survival outcomes was analyzed using the Kaplan-Meier curves and Cox regression models. Results: Patients with an elevated pretreatment NLR exhibited more advanced disease and poorer clinicopathological features. ROC analysis indicated high predictive accuracy of NLR for overall survival (OS; AUC = 0.9066) and event-free survival (EFS; AUC = 0.8669). Kaplan-Meier curves showed significantly worse 5-year OS (66.4% vs. 98.6%; P < 0.001) and EFS (56.8% vs. 94.6%; P < 0.001) in the high NLR group, including those with advanced-stage disease. Multivariate analysis confirmed high NLR as an independent adverse prognostic factor for OS (HR = 12.16, P = 0.035) and EFS (HR = 4.00, P = 0.047), after adjustment for tumor stage, metastasis, and pathological type. Bootstrap internal validation confirmed the robustness of the prognostic model (optimism-corrected C-index = 0.90). Conclusion: Preoperative NLR serves as an independent predictor of prognosis in WTand may represent a convenient and effective biomarker for risk stratification and treatment decision-making.
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