{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T12:07:40Z","timestamp":1771243660988,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Bilateral Wilms tumor (BWT) presents a significant challenge in pediatric oncology, necessitating a delicate balance between achieving oncological control and preserving renal function. While nephron\u2010sparing surgery (NSS) has emerged as a promising alternative to radical nephrectomy, its overall safety and efficacy profile for BWT remains to be consolidated. This systematic review and meta\u2010analysis aimed to synthesize the available evidence to evaluate the pooled safety and efficacy outcomes of NSS in children with BWT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, a systematic search was conducted across five databases (PubMed, Medline, Web of Science, SCOPUS, Cochrane Library). We included studies reporting on pediatric patients with BWT treated with NSS. A single\u2010arm meta\u2010analysis was performed using a random\u2010effects model to pool estimates for survival, recurrence, and renal function outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies comprising 749 patients were included. The pooled overall survival rate was 55.9% (95% CI: 38.2%\u201373.7%), relapse\u2010free survival was 51.4% (95% CI: 32.6%\u201370.3%), and event\u2010free survival was 38.0% (95% CI: 23.3%\u201352.7%). The recurrence rate was 14.9% (95% CI: 9.4%\u201320.5%). Critically, renal function was well\u2010preserved, with a mean glomerular filtration rate (GFR) of 92.0\u2009mL\/min\/1.73\u2009m\u00b2. The need for dialysis (1.7%) and renal transplantation (4.3%) was low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NSS provides a viable surgical strategy for BWT, effectively preserving renal function without unduly compromising survival outcomes. The acceptable recurrence and low renal replacement therapy rates underscore its role in mitigating long\u2010term morbidity. Significant heterogeneity across studies highlights the need for standardized treatment protocols and prospective research to optimize patient selection and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71710","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T04:52:44Z","timestamp":1767070364000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and Efficacy of Nephron\u2010Sparing Surgery in Bilateral Wilms Tumors: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0959-9046","authenticated-orcid":false,"given":"Menna","family":"Sarhan","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Zagazig University Zagazig Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8359-0824","authenticated-orcid":false,"given":"Yasmine Adel","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Faculty of Medicine, Assiut University Assiut Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5905-5271","authenticated-orcid":false,"given":"Ayah","family":"Abdulgadir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Khartoum Khartoum Sudan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1873-1422","authenticated-orcid":false,"given":"Ibrahim","family":"Moqbel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Cairo University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1349-2978","authenticated-orcid":false,"given":"Yehia Nabil","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Zagazig University Zagazig Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2749-8982","authenticated-orcid":false,"given":"Salma","family":"Allam","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Galala University, Galala City Suez Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6479-8547","authenticated-orcid":false,"given":"Ahmad","family":"Alkheder","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Al\u2010Mouwasat University Hospital, Damascus University Damascus Syria"},{"name":"Faculty of Medicine, Damascus University Damascus Syria"},{"name":"Faculty of Medicine, Syrian Private University Damascus Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2598-8620","authenticated-orcid":false,"given":"Khaled Alsayed","family":"Abualkhair","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department Faculty of Medicine, Zagazig University Zagazig Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27430"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20433"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.12-10-1237"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28127"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/00031348231175446"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)68033-0"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.02.025"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26073"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/0189-6725.78669"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-022-05299-5"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-023-05433-x"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.08.017"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-020-0897-3"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_16_17_1","unstructured":"Study Quality Assessment Tools. 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