{"title":"Impact of lateral positioning on upper airway morphology in sedated children under five.","authors":"Hui Li, Xuan Jia, Hui Ye, Jia-Wei Liang, Wen-Li Zhao, Ping Cui, Yaqi Sun, Deng-Ming Lai, Qiang Shu, Yue Jin, Guo-Hao Xie, Xiang-Ming Fang","doi":"10.1007/s12519-025-00910-w","DOIUrl":"https://doi.org/10.1007/s12519-025-00910-w","url":null,"abstract":"<p><strong>Background: </strong>The upper airway morphology in children varies with age and body position. This study aimed to analyze the impact of lateral positioning on the upper airway of sedated children under five.</p><p><strong>Methods: </strong>This retrospective study included pediatric patients who underwent MRI in both the supine and lateral positions at Children's Hospital, Zhejiang University School of Medicine. Upper airway morphology was reconstructed using 3D Slicer software. Python was employed to estimate cross-sectional areas via pixel analysis. The narrowest cross-sectional area, minimal transverse and anteroposterior diameters, airway length, and airway volume were measured and stratified by age for subgroup analysis.</p><p><strong>Results: </strong>In sedated children under 5 years old and when compared to the supine position, lateral positioning increased minimal transverse diameter by 18.70% (P = 0.001), narrowest cross-sectional area by 49.21% (P < 0.001), anteroposterior diameter by 25.54% (P < 0.001), airway volume by 65.64% (P < 0.001), and airway length by 11.93% (P < 0.001). In all subgroups, lateral positioning significantly increased the narrowest cross-sectional area, airway length, and airway volume. However, minimal anteroposterior diameter in the 1-to 3-year age group and minimal transverse diameter in the 3 -to 5-year age group tended to increase in the lateral position but did not reach statistical significance.</p><p><strong>Conclusions: </strong>Lateral position significantly enlarges the upper airway in sedated children under five. These findings support using lateral position to enhance airway patency in younger patients.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhao-Yu Chen, Tian-Nan Zhang, Ji Li, Zhen-Jie Zhang, Hong-Mei Song
{"title":"Tofacitinib: a promising agent for the treatment of persistent rashes in juvenile dermatomyositis.","authors":"Zhao-Yu Chen, Tian-Nan Zhang, Ji Li, Zhen-Jie Zhang, Hong-Mei Song","doi":"10.1007/s12519-025-00901-x","DOIUrl":"10.1007/s12519-025-00901-x","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"419-422"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhi-Peng Shen, Zhong-Yuan Zhang, Nan Li, Liang Xu, Ye Chen
{"title":"Targeted therapy for pediatric glioma: RAF(t)ing in the molecular era.","authors":"Zhi-Peng Shen, Zhong-Yuan Zhang, Nan Li, Liang Xu, Ye Chen","doi":"10.1007/s12519-025-00889-4","DOIUrl":"10.1007/s12519-025-00889-4","url":null,"abstract":"<p><strong>Background: </strong>Pediatric gliomas are the most frequently occurring central nervous system tumors in children. While targeted therapies have been widely applied in the treatment of many adult cancers, their use in pediatric gliomas has lagged behind. However, recent advances in multiomics profiling of pediatric gliomas, coupled with the approval of inhibitors against Raf serine/threonine kinase (RAF), isocitrate dehydrogenase 1/2 (IDH1/2) and neurotrophic receptor tyrosine kinase (NTRK), have spurred significant progress in this field. In light of these developments, this review aims to provide a comprehensive overview of current advancements and the evolving landscape of targeted therapeutic strategies and approaches for pediatric gliomas.</p><p><strong>Data sources: </strong>Data analyzed in this study were obtained from the literature from PubMed, as well as other online databases and websites, including ClinicalTrials.gov and the Pediatric Neuro-Oncology Consortium.</p><p><strong>Results: </strong>Based on findings from multiomics profiling, significant insights have been gained into the genetic and molecular landscape of pediatric gliomas, enabling the identification of key mutations and potentially targetable lesions. These advancements provide rationales for the development of more precise treatment strategies and targeted therapies. Recent approvals of targeted therapies and ongoing clinical trials in pediatric gliomas are converging on the targeting of key signaling molecules and metabolic pathways.</p><p><strong>Conclusions: </strong>In the molecular era, targeted therapies offer new hope for more effective and personalized treatment options for pediatric glioma patients. By developing and tailoring treatments to target specific molecular and metabolic vulnerabilities, targeted therapies have the potential to improve the clinical management of pediatric gliomas, ultimately enhancing both the treatment experience and overall prognosis of these patients.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"338-351"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu-Meng Gao, Bo-Wen Xu, Ping Liu, Yu-Li Wang, Qing-You Zhang, Ying Liao, Jun-Bao Du, Hong-Fang Jin
{"title":"Nomogram and scoring models based on BMI z-score, serum chlorine and urine specific gravity levels for predicting oral rehydration solution efficacy in pediatric postural orthostatic tachycardia syndrome.","authors":"Yu-Meng Gao, Bo-Wen Xu, Ping Liu, Yu-Li Wang, Qing-You Zhang, Ying Liao, Jun-Bao Du, Hong-Fang Jin","doi":"10.1007/s12519-025-00898-3","DOIUrl":"10.1007/s12519-025-00898-3","url":null,"abstract":"<p><strong>Background: </strong>Oral rehydration solution (ORS) is predominantly utilized in the management of hypovolemic postural orthostatic tachycardia syndrome (POTS). This study aimed to identify effective indicators and develop models to assess the impact of ORS on pediatric patients diagnosed with POTS.</p><p><strong>Methods: </strong>We utilized a retrospective analysis of totally 158 pediatric patients with POTS receiving a 3-month course of ORS treatment. All patients were classified into training set (n = 98) and validation set (n = 60). Within the training set, univariate analysis and binary logistic regression were employed to select candidate predictors. To predict the efficacy of ORS in pediatric patients with POTS, a nomogram model and a scoring model were constructed and demonstrated. Additionally, the predictive ability and calibration performance were evaluated using receiver operating characteristic (ROC) curves, Hosmer-Lemeshow (H-L) goodness of fit test, and calibration plots. Decision curve analysis (DCA) was employed to assess the clinical applicability of the predictive models.</p><p><strong>Results: </strong>Body mass index (BMI) z-score, serum chlorine, and urine specific gravity (USG) before treatment were identified as significant and independent predictors of efficacy of ORS in pediatric patients with POTS. Consequently, these indicators were included in the predictive models. A nomogram model was constructed in the training set (AUC = 0.87, which yields a sensitivity of 84.5% and a specificity of 85.0%) and validated in the validation set (the sensitivity, specificity, and accuracy were 87.5%, 85%, and 86.7%, respectively). A scoring model was advanced in the training set (AUC = 0.88, which yields a sensitivity of 79.3% and a specificity of 82.5%) and validated in the validation set (the sensitivity, specificity, and accuracy were 77.5%, 80.0%, and 78.3%, respectively). The H-L test results indicated a good model fit. The calibration plots and DCA for both models exhibited excellent calibration and satisfactory net benefit.</p><p><strong>Conclusions: </strong>Based on pre-treatment BMI z-score, serum chlorine, and USG, a nomogram model and a scoring model were developed and validated. The models can effectively assess the efficacy of ORS in pediatric patients with POTS, offering an accurate and individualized therapeutic strategy.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"406-418"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giovanni Battista Dell'Isola, Antonella Fattorusso, Gianmichele Villano, Pietro Ferrara, Alberto Verrotti
{"title":"Innovating pediatric epilepsy: transforming diagnosis and treatment with AI.","authors":"Giovanni Battista Dell'Isola, Antonella Fattorusso, Gianmichele Villano, Pietro Ferrara, Alberto Verrotti","doi":"10.1007/s12519-025-00904-8","DOIUrl":"10.1007/s12519-025-00904-8","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"333-337"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nowaj Sharif, Ahmad Neyazi, Mahalaqua Nazli Khatib, Lalji Baldaniya, Suhas Ballal, V Kavita, Laxmidhar Maharana, Renu Arya, Ganesh Bushi, Muhammed Shabil, Rukshar Syed, Manika Gupta, Sunil Kumar, Sabah Ansar, Sanjit Sah, Diptismita Jena, Prakasini Satapathy
{"title":"Anemia in Asian children: trends in the prevalence, etiology and analysis of geographic inequalities.","authors":"Nowaj Sharif, Ahmad Neyazi, Mahalaqua Nazli Khatib, Lalji Baldaniya, Suhas Ballal, V Kavita, Laxmidhar Maharana, Renu Arya, Ganesh Bushi, Muhammed Shabil, Rukshar Syed, Manika Gupta, Sunil Kumar, Sabah Ansar, Sanjit Sah, Diptismita Jena, Prakasini Satapathy","doi":"10.1007/s12519-025-00897-4","DOIUrl":"10.1007/s12519-025-00897-4","url":null,"abstract":"<p><strong>Background: </strong>Pediatric anemia is a pervasive public health issue in Asia, significantly impairing children's growth, cognitive development, and future potential. This study evaluates trends, prevalence, and socio-economic disparities of pediatric anemia across Asia from 1990 to 2021, leveraging data from the Global Burden of Disease Study (GBD) 2021 study.</p><p><strong>Methods: </strong>Using estimated annual percentage change (EAPC) and Pearson's correlation coefficient, geographic variations and temporal trends were analysed alongside associations between prevalence, years lived with disability (YLDs), and Socio-demographic index (SDI).</p><p><strong>Results: </strong>The study reveals a modest overall decline in anemia prevalence by 11.9%, from 464.53 million cases in 1990 to 409.07 million in 2021. High-SDI regions such as East Asia achieved significant reductions (- 71.36%), with countries like Singapore, the Republic of Korea, Seychelles, Qatar, and the United Arab Emirates (UAE) showing substantial progress. In stark contrast, low-SDI countries, including Yemen (108.34%) and Afghanistan (130.28%), along with Cambodia, India, and Pakistan, experienced alarming increases. Dietary iron deficiency was the dominant cause, followed by hemoglobinopathies and neglected tropical diseases. Females, particularly adolescents, and children under five faced disproportionate burdens, with prevalence rates in low-SDI regions exceeding 47,000 per 100,000 compared to < 10,000 per 100,000 in high-SDI areas.</p><p><strong>Conclusions: </strong>These findings emphasize profound regional and socio-economic inequalities in anemia burden. Urgent, evidence-based interventions are imperative, focusing on enhancing nutrition, expanding healthcare access, and integrating sex-sensitive strategies to address this multifaceted issue. Strengthened policies and targeted actions are critical to mitigating the burden and fostering health equity, particularly in vulnerable low-SDI regions.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"396-405"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gaps and challenges in the management of pediatric steatotic liver diseases: a narrative review.","authors":"Wathsala Hathagoda, Shaman Rajindrajith, Madunil Anuk Niriella","doi":"10.1007/s12519-025-00902-w","DOIUrl":"10.1007/s12519-025-00902-w","url":null,"abstract":"<p><strong>Background: </strong>Given the rising prevalence of pediatric steatotic liver disease (SLD), it is imperative to identify and address common challenges in clinical practice. This article aims to examine key issues in managing pediatric SLD and attempts to propose evidence-based recommendations.</p><p><strong>Data sources: </strong>We reviewed published literature on steatotic liver diseases in children focusing on overweight and obesity, including original research, systematic reviews, meta-analyses, consensus statements, and position papers. Databases searched were PubMed/MEDLINE, Cochrane Library, Web of Science, and Scopus. Search terms included: \"non-alcoholic fatty liver disease\", \"NAFLD\", \"steatohepatitis\", \"NASH\", \"steatotic liver disease\", \"fatty liver\", \"children\", \"adolescents\", \"pediatric\", \"obesity\", and \"overweight\".</p><p><strong>Results: </strong>Critical issues include an over-reliance on liver biochemistry, which may fail to capture the broader spectrum of SLD [e.g., metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction associated with steatohepatitis (MASH)], and delays in recognizing metabolic comorbidities. Dietary and lifestyle recommendations are often generalized, overlooking individual patient needs, while psychological factors, such as stress and mental health, are frequently neglected despite their role in disease progression. Advanced fibrosis cases are under-referred, long-term risks like cirrhosis are underestimated, and insufficient follow-up, coupled with limited family involvement in education, further compromises care.</p><p><strong>Conclusions: </strong>Addressing these deficiencies through a multidisciplinary approach that incorporates early diagnosis, personalized treatment strategies, structured monitoring, and comprehensive family involvement is imperative for optimizing outcomes and mitigating the long-term impact of pediatric SLD.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"352-360"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhe Lu, Li-Wen Tan, Hong Xu, Zheng-Kun Xia, Xiao-Yun Jiang, Xiao-Chuan Wu, Fang Wang, Xiao-Rong Liu, Cheng-Guang Zhao, Xiao-Zhong Li, Jian-Hua Mao, Xiao-Wen Wang, Wen-Yan Huang, Xiao-Shan Shao, Jian-Jiang Zhang, Shi-Pin Feng, Jun Yang, Qiu Li, Ai-Hua Zhang, Mo Wang
{"title":"Performance of EMA algorithm, 2022 ACR/EULAR criteria, and EMA-ACR/EULAR algorithm in classifying pediatric ANCA-associated vasculitis: a national cohort study in China.","authors":"Zhe Lu, Li-Wen Tan, Hong Xu, Zheng-Kun Xia, Xiao-Yun Jiang, Xiao-Chuan Wu, Fang Wang, Xiao-Rong Liu, Cheng-Guang Zhao, Xiao-Zhong Li, Jian-Hua Mao, Xiao-Wen Wang, Wen-Yan Huang, Xiao-Shan Shao, Jian-Jiang Zhang, Shi-Pin Feng, Jun Yang, Qiu Li, Ai-Hua Zhang, Mo Wang","doi":"10.1007/s12519-025-00899-2","DOIUrl":"10.1007/s12519-025-00899-2","url":null,"abstract":"<p><strong>Background: </strong>Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a type of necrotizing vasculitis with poor prognosis, which is more severe in children. Classifying AAV patients may be helpful for diagnosis and management. However, present classification criteria for pediatric AAV are developed mainly based on adults, which have limitations in clinical practice. In this study, we introduced an updated algorithm based on the European Medicines Agency (EMA) algorithm in conjunction with the American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) criteria. This new approach aims to resolve the issue of duplicate classification present in the 2022 ACR/EULAR criteria and to refine the existing EMA algorithm.</p><p><strong>Methods: </strong>This study included 179 pediatric patients diagnosed with AAV across 17 centers in China. Patients were classified using the EMA algorithm, the ACR/EULAR criteria, and the EMA-ACR/EULAR algorithm. The Kappa value and Net Reclassification Index (NRI) were used to evaluate the classification performance of these criteria.</p><p><strong>Results: </strong>According to the EMA algorithm, 136 (76.0%) patients were classified with microscopic polyangiitis (MPA) and 14 (7.8%) with granulomatosis with polyangiitis (GPA), while 29 (16.2%) remained unclassifiable. According to the ACR/EULAR criteria, 145 (81.0%) patients were classified with MPA, 14 (7.8%) with GPA, 2 (1.1%) with eosinophilic granulomatosis with polyangiitis (EGPA), and 4 (2.2%) with both MPA and GPA, while 14 (7.8%) remained unclassifiable. The EMA-ACR/EULAR algorithm classified 124 patients (69.3%) as MPA, 26 (14.5%) as GPA, and 2 (1.1%) as EGPA, while 27 (15.1%) were unclassified. The Kappa values between the EMA algorithm and ACR/EULAR criteria for GPA and MPA were 0.225 [95% confidence interval (CI) 0.000-0.456, P = 0.003] and 0.357 (95% CI 0.196-0.518, P < 0.001). Compared to these two criteria, the EMA-ACR/EULAR algorithm demonstrated positive NRIs in the classification of both GPA (0.702, 95% CI 0.258-1.146, P = 0.002; 0.547 95% CI 0.150-0.944, P = 0.007) and MPA (0.425, 95% CI 0.209-0.642, P < 0.001; 0.519, 95% CI 0.305-0.733, P < 0.001).</p><p><strong>Conclusions: </strong>The EMA-ACR/EULAR algorithm addresses the limitations of the 1990 ACR criteria within the EMA framework and resolves the issue of duplicate classification in the 2022 ACR/EULAR criteria. However, further research is necessary to validate the superiority of the EMA-ACR/EULAR algorithm in the clinical classification of pediatric AAV patients.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"372-385"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shen Yang, Jing-Hao Yan, Jin-Hu Wang, Hong Qin, Wei Yang, Kui-Ran Dong, Jun-Cheng Liu, Min Xu, Yi-Zhuo Zhang, Jian-Guo Zhang, Ye-Ming Wu, Qiang Zhao, Shan Wang, Jing-Fu Wang, Jian Chang, Rong-De Wu, Xiang-Ling He, Tao Li, Yan Su, Ju Gao, Hui Li, Xiao-Mei Yang, Xiao-Juan Wu, De-Guang Meng, Paul D Losty, Chan Hon Chui, Xiao-Feng Chang, Hong-Cheng Song, Huan-Min Wang
{"title":"Clinical and prognostic characteristics of bilateral Wilms tumor: a multi-center institutional retrospective cohort study experience from China.","authors":"Shen Yang, Jing-Hao Yan, Jin-Hu Wang, Hong Qin, Wei Yang, Kui-Ran Dong, Jun-Cheng Liu, Min Xu, Yi-Zhuo Zhang, Jian-Guo Zhang, Ye-Ming Wu, Qiang Zhao, Shan Wang, Jing-Fu Wang, Jian Chang, Rong-De Wu, Xiang-Ling He, Tao Li, Yan Su, Ju Gao, Hui Li, Xiao-Mei Yang, Xiao-Juan Wu, De-Guang Meng, Paul D Losty, Chan Hon Chui, Xiao-Feng Chang, Hong-Cheng Song, Huan-Min Wang","doi":"10.1007/s12519-025-00895-6","DOIUrl":"10.1007/s12519-025-00895-6","url":null,"abstract":"<p><strong>Background: </strong>This multi-center analysis of data from China reviews the management and long-term outcomes of patients with bilateral Wilms tumors (BWT), and explores prognostic risk factors.</p><p><strong>Methods: </strong>We retrospectively analyzed a cohort of pediatric patients with synchronous BWT treated at 18 pediatric oncology centers in China between 2006 and 2023. The overall survival (OS) and event-free survival (EFS) rates were calculated using Kaplan-Meier methodology. Prognostic risk factors were determined using univariable and multivariable analysis.</p><p><strong>Results: </strong>A total of 167 patients with BWT and a median age at diagnosis of 13 months (range 0-78 months) were included in the study. Neoadjuvant chemotherapy was administered to 149 index cases; tumor biopsy was performed before initiating chemotherapy in 70 patients. One hundred and three children underwent bilateral nephron-sparing surgery (NSS) and two hundred fifty-two of the three hundred one kidneys underwent NSS. The four-year OS and EFS rates in the study cohort were 86.5% and 77.8%. After a median follow-up of 50 months, four patients developed renal failure requiring dialysis and a single patient received a kidney transplant 26 months postoperatively.</p><p><strong>Conclusions: </strong>Regarding prognostic factors, the results of the multifactor analysis indicate that distant metastasis and positive surgical margins have negative impacts on OS and distant metastasis had a negative effect on EFS. Distant metastasis and positive surgical margins affect the long-term prognosis of BWT. Video Abstract (MP4 19393 KB).</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"386-395"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}