Current concepts in surgery for XXXX -the risk and function-adapted strategy.

@entity1 @entity1538 @entity5 @entity3969 @entity703
This article describes the current status of surgical @entity3969 . Combined multimodal treatment including classical @entity1538 is still the most recommended and offers excellent survivals. @entity1 suffering from @entity3969 as potentially very long-term survivors also need great care of quality of their further life. Nephron-sparing surgery seems an important step in this regard; however, selection of @entity1 is necessary to avoid failures and decreasing survival rate. A new method of describing this kind of procedure developed within the SIOP @entity703 Study Group (RTSG) offers an opportunity for further comparisons and assessment. Minimally invasive nephrectomy is not recommended in the treatment of @entity3969 ; however, in experienced hands and correctly selected (rare) cases, minimally invasive nephrectomy may offer the same outcome as the classical open approach. Lymph nodes sampling, essential for reliable @entity5 , appeared rarely correct in @entity1 operated by this technique. Any competition with partial nephrectomy should be avoided in favor of the nephron-sparing approach. A small proportion of @entity1 still create surgical difficulties and this is in fact the target group for further surgical reviews. Their prognosis seems at least in part surgeon-dependent. Few clinical factors available preoperatively ( @entity5 side, age, and @entity5 volume) were detected as influencing potential risk of surgical failures. Once identified, this needs increased attention from the surgical point of view.
