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Lymph node sampling
Source: Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 15, 2025 · Captured 2026-09-09.
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Context: Wilms Tumor / Treatment of Wilms Tumor / Treatment option overview for Wilms tumor / Surgery
Lymph node status is a major long-term predictor of outcome in patients with Wilms tumor.[228] Data from Wilms tumor studies suggest that the lymph node number and location may impact therapy and outcome, although NWTS and COG renal tumor protocols have never defined the number of lymph nodes or locations of lymph nodes to be sampled.[228] The ideal number of lymph nodes that should be sampled remains unknown.
The 5-year OS rate was lower for patients with 0 lymph nodes sampled (87% vs. 91% for 1–5 lymph nodes, 93% for 6–10 lymph nodes, 95% for >10 lymph nodes; P = .005). Multivariate analysis confirmed a survival advantage for patients having 1 to 5 lymph nodes sampled (HR, 0.6; P = .016), 6 to 10 lymph nodes sampled (HR, 0.521; P = .048), and >10 lymph nodes sampled (HR, 0.403; P = .039), compared with patients with 0 lymph nodes examined.[240]
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In NWTS-5, failure to sample lymph nodes was associated with higher risk of relapse in stage I and II patients.[241] AREN0532 showed similar results with a poorer EFS observed for patients who did not have a lymph node biopsy. The EFS for stage III patients without lymph node sampling was 84% (n = 148), compared with 89% for those patients who had lymph node sampling (n = 387) (P = .067).[242]
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