Expert consensus on surgical management of unilateral Wilms tumor (2025)

Wilms tumor (WT) is the most common primary malignant renal tumor in children. Currently, there is no unified consensus regarding surgical management of WT. This is particularly so in complex cases where tumors are large, where there is invasion of adjacent organs, for nephron-sparing procedures, and for lymph node biopsy. Non-standardized surgical procedures can lead to tumor recurrence and progression; this is of increasing clinical concern. Standardizing the surgical approach and protocols for WT is therefore of great importance to improving treatment outcomes and patient prognosis. To better guide clinical practice, the Oncology Surgery Group and Urology Surgery Group of Pediatric Surgery Branch of the Chinese Medical Associationhave formulated this expert consensus. Based on previous clinical research findings and existing guidelines, the consensus provides specific recommendations for surgical approach and for decision-making.