title: Oncologic outcomes of partial versus radical nephrectomy for unilateral Wilms tumor.
abstract: BACKGROUND
  Radical nephrectomy (RN) is the recommended surgical management as part of multi-modality therapy for unilateral Wilms tumor (UWT). Based on recent data demonstrating that renal preserving surgery decreases the likelihood of chronic renal disease and associated co-morbidities, we analyzed oncologic outcomes of patients after partial nephrectomy (PN) for UWT.
  
  
  METHODS
  We identified all published cases of PN for UWT. Cases of elective PN for UWT were analyzed for tumor stage, presence, timing and location of disease recurrence, and overall survival (OS). Eighty-two patients had adequate data for analysis. For comparison, these endpoints were collected on consecutive children undergoing RN for UWT from 1985 to 2010 at our institution.
  
  
  RESULTS
  Of the 82 PN patients, tumor stage was: I-64, II-10, III-6, IV-2. Of the 121 RN patients, the staging was: I-24, II-45, III-29, IV-23. In the PN group, at a median of 48 months (3-372), the recurrence-free survival (RFS), local RFS and OS were 89.1%, 92.7%, and 95.1%, respectively. In the RN group, at a median of 69 months (0-214), the RFS, local RFS, and OS were 83.1%, 95.0%, and 95.0%, respectively. After controlling for stage, there were no statistically significant differences in the above oncologic outcomes between the groups.
  
  
  CONCLUSIONS
  Based on reported data, the oncologic outcomes of PN for UWT in selected patients do not appear to differ from those of RN. PN for appropriately selected patients with UWT should be studied in prospective, co-operative group trials.
authors: Division of Pediatric Urology, University of Texas, Dallas, TX, USA. nicholas.cost@utsouthwestern.edu
authors: Nicholas G
authors: NG
authors: Cost
authors: Jessica D
authors: JD
authors: Lubahn
authors: Candace F
authors: CF
authors: Granberg
authors: Bruce J
authors: BJ
authors: Schlomer
authors: Jonathan E
authors: JE
authors: Wickiser
authors: Dinesh
authors: D
authors: Rakheja
authors: Patricio C
authors: PC
authors: Gargollo
authors: David
authors: D
authors: Leonard
authors: Ganesh V
authors: GV
authors: Raj
authors: Linda A
authors: LA
authors: Baker
authors: Vitaly
authors: V
authors: Margulis
mesh_terms: D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000401:mortality* / Q000473:pathology / Q000601:surgery*