Prediction of pediatric Wilms tumor recurrence using interpretable machine learning models: insights from a 20-year real-world study and the prognostic value of Ki-67

Despite overall survival exceeding 80% in Wilms tumor (WT), approximately 15% of pediatric patients experience recurrence with poor post-relapse survival (~50%) and significant long-term complications, highlighting an unmet need for precise recurrence prediction. To address this, we developed and validated machine learning (ML) models for predicting postoperative WT recurrence using real-world cli…