Background: Wilms Tumor (WT) is the most common primary renal malignancy in
children. Autophagy plays dual roles in the promotion and suppression of various cancers.
Objective: The goal of our study was to develop a novel autophagy-related gene (ARG) prognostic
nomogram for WT.
Methods: The Cancer Genome Atlas (TCGA) database was used. We screened the expression
profiles of ARGs in 136 WT patients. The differentially expressed prognostic ARGs were
evaluated by multivariate Cox regression analysis and survival analysis. A novel prognostic
nomogram based on the ARGs and clinical characteristics was established using multivariate Cox
Results: First, 69 differentially expressed ARGs were identified in WT patients. Then, multivariate
Cox regression analysis was used to determine 4 key prognostic ARGs (CC3CL1, ERBB2, HIF-α
and CXCR4) in WT. According to their ARG expression levels, the patients were clustered into
high- and low-risk groups. Next, survival analysis indicated that high-risk patients had significantly
poorer overall survival than low-risk patients. The results of functional enrichment analysis
suggested that autophagy may play a tumor-suppressive role in the initiation of WT. Finally, a
prognostic nomogram with a Harrell's concordance index (C-index) of 0.841 was used to predict
the survival probability of WT patients by integrating clinical characteristics and the 4-ARG
signature. The calibration curve indicated its excellent predictive performance.
Conclusion: In summary, the ARG signature could be a promising biomarker for monitoring the
outcomes of WT. We established a novel nomogram based on the ARG signature, which
accurately predicts the overall survival of WT patients.