Clinical and Pathologic features of 535 Patients with Congenital Mesoblastic Nephroma
Bibliographic record
Abstract
OBJECTIVE: To explore clinicopathologic features of children with congenital mesoblastic nephroma (CMN) enrolled on Children's Oncology Group study AREN03B2 and a historical cohort of CMN patients. BACKGROUND: CMN is a pediatric renal tumor of infancy, with histologic subtypes of cellular, mixed, and classic. Given its rarity, evidence-based clinical practice guidelines are unavailable. We collected clinicopathologic findings and outcomes data in 2 large cohorts of children with CMN. METHODS: From 2004-2019, 6412 patients enrolled in AREN03B2 and underwent prospective central review of pathology materials, imaging studies, and operative reports. CMNs were identified and subclassified. Similar data was extracted from a historical cohort of CMNs collected by pathology reviewers between 1973-2001. RESULTS: In total, 535 children were included (139 from AREN03B2; 396 from the historical cohort). In the ARE03B2 cohort, 137 had available follow-up data (median follow-up: 4.5 y). Ten children (7.2%) relapsed, and 4/10 children died of disease. Four of 55 (7.3%) children with local stage II cellular or mixed CMNs relapsed, and 6/37 (16.2%) children with local stage III cellular or mixed CMNs relapsed. No child with local stage I or classic CMNs (of any stage) relapsed. All relapses occurred within 1.5 years of diagnosis, and 4/10 relapses occurred within 3 months. In the historical cohort, 31 children (7.8%) relapsed; all relapses were local stage II or III cellular or mixed. CONCLUSIONS: While recurrences are uncommon, they are highly associated with cellular or mixed histologic subtypes and stage, providing key clinical information that may guide consideration of therapy and surveillance.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".