IGF1 and cancer: These cells exhibit characteristics of cancer stem cells and nephron progenitors, residing in immune-desert niches surrounded by CAFs, and interact through signaling pathways such as IGF, PDGF, and SLIT2. To facilitate clinical applications, we developed an ensemble machine learning model based on Scissor+ signatures, which not only accurately predicts RFS but also outperforms clinical features and reveals adverse genomic alterations.