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The survival rate of patients treated for Wilms' tumor (nephroblastoma) has increased steadily over the past three decades. Ladd and White21 were the first to show that prompt and thorough surgery, in conjunction with better preoperative and postoperative care, improved the survival rate. This was the first of three important advances in the treatment of this malignancy, and the evidence still favors the concept that surgical removal of the tumor mass should be the first step carried out, in order to insure the best results from radiotherapy and chemotherapy. Surgery alone has been effective in a few cases. For instance, in the series from Squier Urological Clinic, published in 1959,22 four of the five patients treated with nephrectomy alone survived more than five years (Table 2). The larger collected series of Klapproth,23 however, showed that the results of nephrectomy alone were not as good as those obtained
Lattimer JK, Conway GF. The Place of Surgery in Wilms' Tumors. JAMA. 1968;204(11):985-986. doi:10.1001/jama.1968.03140240041011