Table 3 Classification of nephron-sparing

From: Rationale for the treatment of Wilms tumour in the UMBRELLA SIOP–RTSG 2016 protocol

Aspect*

Description

Surgical technique

• NSS (A) = Partial Nephrectomy = resection of tumour with a rim of normal renal parenchyma

• NSS (B) = Enucleation = resection of tumour without a rim of normal renal parenchyma

Surgical resection margin (SRM)

• Intact pseudo-capsule = (0)

• Doubt = (1)

• Tumour breach = (2)

Pathological resection margin (PRM)

• Safe rim of renal parenchyma on resection margin, except nephroblastomatosis = (0)

• Intact pseudocapsule along the resection margin = (1)

• Tumour breach = (2)

Remaining renal parenchyma (RRP)

• A subjective evaluation is done by the surgeon of the percentage of renal parenchyma remaining on the operated kidney = (n %)

• For example, a polar nephrectomy usually corresponds to a RRP of 70%.

  1. NSS, nephron-sparing surgery
  2. *A classification for each case would be reported as follows: NSS(X)-SRM(n)-PRM(n)-RRP(n%). Adapted from Godzinski, J. et al. Current concepts in surgery for Wilms tumour−the risk and function-adapted strategy. Eur. J. Pediatr. Surg. 24, 457–460 (2014). © Georg Thieme Verlag KG.
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