{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T16:42:45Z","timestamp":1786207365189,"version":"build-2736575974"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Fundaci\u00f3 Instituci\u00f3 dels Centres de Recerca de Catalunya"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of bilateral Wilms tumor (BWT) to achieve complete tumor control and maintain good long-term renal function is challenging. Nephron-sparing surgery (NSS) allows preservation of renal parenchyma and reduces the risk of renal failure in selected cases. However, there is no standardized surgical strategy. This study analyzed the surgical management for patients included in the SIOP2001 trial and its outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective review analyzed French patients included in the SIOP 2001 protocol for synchronous BWT. Data regarding imaging, surgical strategy, complications, histology, oncologic outcomes, and renal function were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 96 patients (median age, 15 months; range, 0\u2013143 months). They received surgery for 122 Wilms tumors, and 56 (45.9 %) kidneys benefited from NSS. Total nephrectomy (TN) was performed in 27\/35 (77.1 %) and 33\/76 (43.4 %) of the histologies non-sensitive to chemotherapy (stromal and diffuse anaplasia, respectively). For bilateral surgery, the study found a trend to more TNs, tumoral rupture, and death among the patients who had surgery in a single stage (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.05). Tumor rupture was associated with higher tumoral volume (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). In a review of preoperative images, vascular contact was the main factor associated with TN. Additional chemotherapy did not seem to significantly reduce this contact or the number of TNs in these patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Whenever possible, NSS should be prioritized for patients with BWT. In this study, the most limiting factor was contact with vascular structures. Additional chemotherapy for tumors with non-sensitive histology or extensive vascular contact had little impact on the final surgical strategy. Staged surgery should be considered as it appeared to reduce surgical morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-026-19859-9","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T16:58:11Z","timestamp":1780592291000},"page":"8505-8513","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral Wilms Tumor: Looking for the Best Surgical Strategy"],"prefix":"10.1245","volume":"33","author":[{"given":"Marta","family":"Martos Rodr\u00edguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Sudour-Bonnange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Ducou Le Pointe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauriane","family":"Lemelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacinthe","family":"Bonneau-Lagacherie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pasqualini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Boulanger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Notz-Carrere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Mansuy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Pluchart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Rod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Jannier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Sirvent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Plantaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Andry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnauld","family":"Verschuur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Dumont","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Audry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Irtan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"19859_CR1","doi-asserted-by":"publisher","unstructured":"Vujani\u0107 GM, Gessler M, et al. On behalf of the international society of paediatric oncology\u2013renal tumour study group (SIOP\u2013RTSG). The UMBRELLA SIOP\u2013RTSG 2016 Wilms tumour pathology and molecular biology protocol. Nat Rev Urol. 2018;15:693\u2013701. https:\/\/doi.org\/10.1038\/s41585-018-0100-3.","DOI":"10.1038\/s41585-018-0100-3"},{"key":"19859_CR2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26547","volume":"64","author":"GM Vujani\u0107","year":"2017","unstructured":"Vujani\u0107 GM, Apps JR, Moroz V, et al. Nephrogenic rests in Wilms tumors treated with preoperative chemotherapy: the UK SIOP Wilms Tumor 2001 Trial experience. Pediatr Blood Cancer. 2017;64:e26547. https:\/\/doi.org\/10.1002\/pbc.26547.","journal-title":"Pediatr Blood Cancer."},{"key":"19859_CR3","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s00383-016-4047-2","volume":"33","author":"AJW Millar","year":"2017","unstructured":"Millar AJW, Cox S, Davidson A. Management of bilateral Wilms tumours. 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