Prognostic factors in renal cell carcinoma

Renal cell carcinoma (RCC) remains a major source of morbidity and mortality. Approximately 40% of patients eventually die of cancer progression, making RCC the most lethal of the common urologic malignancies. Even in the contemporary era, approximately 20% of patients present with metastatic disease, and 30% to 40% of patients with surgically resectable disease have a recurrence during surveillance [1]. Prognosticators for these adverse events are vitally important for a rational approach to the management of RCC. In addition, reliable predictive factors are essential for stratification of patients into clinical trials for RCC and can provide an important reference point for comparison of data from different institutions and various treatment protocols. This article reviews the clinical, laboratory, and pathologic findings that are now established prognostic factors for RCC (Box 1) and highlights the more recent innovative efforts to integrate these parameters and thereby improve the predictive power for patients with this disease.