Wilms tumor is the most common pediatric renal neoplasm, accounting for approximately 6% of all childhood cancers [1,2]. Favorable histology Wilms tumor (FHWT) represents approximately 90% of all Wilms tumors and is associated with a favorable overall survival (OS) rate of approximately 90% [3]. However, the prognostic assessment of FHWT remains challenging due to its dependence on clinical, pathological, and molecular variables [4], [5], [6]. FHWT can be stratified into different risk groups based on clinical and pathological features, including age, tumor stage, and histologic subtype [7]. Although the National Wilms Tumor Study (NWTS) and Children's Oncology Group have established risk-based treatment protocols for FHWT, these protocols are associated with substantial treatment-related morbidity and long-term adverse effects [8]. Prognostic assessment of FHWT is crucial for treatment decision-making and optimal patient outcomes. Several prognostic factors have been identified, including age, tumor stage, and histologic subtype. However, integrating these factors to develop personalized prognostic assessments can be challenging [9]. Nomograms have emerged as powerful tools to integrate multiple prognostic factors and provide personalized probabilities of clinical outcomes. Nomograms have been developed for several pediatric malignancies, but to date, no nomogram has been developed to predict the event-free survival (EFS) of FHWT patients.

The development of a reliable nomogram for personalized prognostic assessment of FHWT based on clinical and pathological variables could improve the accuracy of prognostic assessment and facilitate individualized treatment decision-making for FHWT patients, while minimizing treatment-related morbidity and long-term adverse effects [10]. Thus, the objective of this study was to construct and validate a nomogram for personalized prognostic assessment of FHWT based on clinical and pathological variables.