PURPOSE: After nephrectomy for unilateral @entity3969 ( @entity3969 ), two potential hazards threaten the remaining kidney. The development of a metachronous @entity3969 (2% to 3%), and decrease in renal function after chemotherapy. Our study aims included: (1) to clarify how many @entity3969 @entity1 could benefit from @entity1625 ( @entity1625 ) without jeopardizing the high cure rate, (2) to establish the function of the kidney remnant, and (3) to test the radiological criteria for preoperative selection of @entity1625 candidates. METHODS: A retrospective analysis of 90 consecutive cases of histologically verified @entity3969 (1982 to 1992) was carried out. Data were studied independently by the surgeon, the radiologist, and the pathologist. The preoperative selection criteria for @entity1625 were functioning kidney, @entity5 confined to upper or lower pole leaving two thirds of the @entity703 free, and no hilar or vascular structures involved. After @entity1625 , renal function was estimated by a calculated creatinine clearance (CC) combined with the assessment of the relative function of each kidney by renal scintigraphy. RESULTS: There were 46 @entity1 and 44 @entity1 with median age at diagnosis of 3 years 6 months (range, 3 months to 16 years 7 months). Stage I disease occurred in 40 @entity1 , stage II in 23, stage III in 16, and stage IV occurred in 11 @entity1 . Nearly all @entity1 received preoperative chemotherapy. Radiological analysis of 85 available data sets (5 missing) suggested that @entity1625 was possible in 13 @entity1 , and data were inconclusive in two. All 13 @entity1 selected by the radiologist appeared to be in agreement with the pathological criteria for resectability. Of these cases, complete resection by @entity1625 was performed in five, could have been possible in retrospect in two, and appeared impossible in six. In two more @entity1 , @entity1625 was performed; in both cases the radiologist had predicted @entity1625 to be impossible. Median follow-up after @entity1625 was 61 months, range, 45 to 167 months. Two @entity1 died of distant @entity3 , and no local recurrence occurred. Five are in remission with a median CC level of 110 mL/min, range, 85 to 124. Relative functions of the kidney remnants were 20% to 50%. @entity717 for progressive obstruction was performed in one, but CC level remained normal (85 mL/min). Comparing the preoperative radiological prediction with the combined surgical and pathological findings in a 2 x 2 frequency table, the sensitivity of the radiological findings could be calculated to be 80%, the specificity 97%, and the accuracy 87%. CONCLUSIONS: (1) Partial nephrectomy is safe in approximately 10% of @entity3969 @entity1 . (2) The function of the kidney remnant remains well, and even permits @entity717 . (3) Preoperative imaging shows an accuracy of 87% to predict the possibility for @entity1625 .

Is XXXX appropriate treatment for unilateral @entity3969 ?

@entity1 :: ('9606', 'Species') :: ['patients', 'boys', 'girls'] @entity1625 :: ('MESH:D004828', 'Disease') :: ['PN', 'partial nephrectomy'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity3969 :: ('MESH:D009396', 'Disease') :: ["Wilms' tumor", 'WT'] @entity717 :: ('MESH:D009069', 'Disease') :: ['Contralateral nephrectomy', 'contralateral nephrectomy'] @entity703 :: ('MESH:D007680', 'Disease') :: ['kidney tumor']
@entity1625 :: (MESH:D004828,Disease) :: ['partial nephrectomy']
