Nephron-sparing surgery for bilateral Wilms tumor

Synchronous bilateral disease occurs in approximately 5 % of children with Wilms tumor (WT), and is independently associated with an increased risk of renal insufficiency. Nephron-sparing surgery (NSS) allows preservation of renal mass and improved renal function. Published oncologic and functional outcomes with NSS to date are generally good, likely reflecting proper patient selection and excellent surgical technique during tumor excision, as well as appropriate use of upfront and adjuvant therapies. Here we highlight important issues regarding the use of NSS in children with bilateral Wilms tumor (BWT).