Newarticle you should know by Cecilia Gigena
"Efficacy and late kidney effects of nephron-sparing surgery in the management of unilateral Wilms tumor: a systematic review and meta-analysis"
Authors: Shan Li, Jinkui Wang, Mujie Li, Zhaoxia Zhang, Tao Mi, Xin Wu, Zhang Wang, Liming Jin, Dawei He
Full article: https://gcmd.co/3vgzJ9c
Abstract
To evaluate the efficiency and long-term renal function of nephron sparing surgery (NSS) in unilateral WT patients compared with radical nephrectomy (RN). The review was performed following Cochrane Handbook guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched five databases (Pubmed, Embase, Scopus, Web of Science and Cochrane) for studies reporting the efficiency and late renal function of NSS and/or RN on February 10, 2023. Comparative studies were evaluated by Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) and RoB 2.0. Assessed outcomes included survival rate, relapse rate, eGFR, renal dysfunction and hypertension. 26 studies involving 10322 unilateral WT cases underwent RN and 657 unilateral WT cases underwent NSS were enrolled. Overall effect estimates demonstrated that NSS significantly increased eGFR at follow-up (SMD, 0.38; 95% CI 0.05-0.72; p = 0.025) compared to that at diagnosis, and RN did not significantly decrease eGFR at follow-up (SMD, - 0.33; 95% CI - 0.77-0.11; p = 0.142) compared to that at diagnosis. Moreover, no significant difference was found in outcomes of survivability (OR, 1.38; 95% CI 0.82-2.32; p = 0.226), recurrence (OR, 0.62; 95% CI 0.34-1.12; p = 0.114), eGFR at follow-up (SMD, 0.16; 95% CI - 0.36-0.69; p = 0.538), renal dysfunction (OR, 0.36; 95% CI 0.07-1.73; p = 0.200) and hypertension (OR, 0.17; 95% CI 0.03-1.10; p = 0.063). Current evidence suggests that NSS is safe and effective for unilateral WT patients, because it causes better renal function and similar oncological outcomes compared with RN. Future efforts to conduct more high-quality studies and explore sources of heterogeneity is recommended.
Type: video · 0 min · posted 2024-03-13 Canonical: https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077 ## Chapters - [0:00](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=0) Nephron-sparing surgery versus radical nephrectomy in unilateral Wilms tumor ## Statements - "The systematic review and meta-analysis was conducted in Chongqing, China" — Cecilia Gigena (epidemiological) [0:12](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=12) - "The study aimed to evaluate efficacy and long-term renal function after nephron-sparing surgery in patients with unilateral Wilms tumor" — Cecilia Gigena (clinical) [0:12](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=12) - "The analysis included 26 studies" — Cecilia Gigena (epidemiological) [0:27](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=27) - "Nephron-sparing surgery increased glomerular filtration rate after surgery" — Cecilia Gigena (clinical) [0:27](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=27) - "There were no significant differences in overall survival between nephron-sparing surgery and radical nephrectomy" — Cecilia Gigena (clinical) [0:27](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=27) - "There were no significant differences in recurrence rates between nephron-sparing surgery and radical nephrectomy" — Cecilia Gigena (clinical) [0:27](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=27) - "There were no significant differences in hypertension rates between nephron-sparing surgery and radical nephrectomy" — Cecilia Gigena (clinical) [0:27](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=27) - "There were no significant differences in renal dysfunction rates between nephron-sparing surgery and radical nephrectomy" — Cecilia Gigena (clinical) [0:27](https://library.globalcastmd.com/watch/efficacy-and-late-kidney-effects-of-nephron-sparing-surgery-in-the-management-of-unilateral-wilms-tumor-8077?t=27) ## Transcript Do you do nephrine sparing surgery or radical nephrectomy when you're treating a unilateral wounds tumor? Hi, I'm Cecilia Genna from Cincinnati Children's Hospital, and I think this is an article that you should know about. This is a systematic review and meta-analysis done in Chongqing, China that aimed to evaluate the efficacy and long-term renal function after nephrine sparing surgery in patients with unilateral Wilms tumor. And what did they find? They gathered 26 studies, and what they found is that nephrine sparing surgery increased the glomerular filtration after surgery, with no significant differences in overall survival, recurrences, hypertension, or renal dysfunsion compared to radical nephrectomy. Let us know what you think and stay tuned for more articles that you should know about. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai