title: Prognostic factors and predictive models in renal cell carcinoma: a contemporary review.
abstract: BACKGROUND
  The natural history of renal cell carcinoma (RCC) is highly unpredictable. Small renal masses may be accompanied by metastatic disease. Conversely, patients with locally advanced disease may enjoy long-term disease-free survival.
  
  
  OBJECTIVE
  To review the status of prognostic factors in RCC.
  
  
  METHODS
  A literature review was performed using the PubMed, MEDLINE, and Cochrane databases for articles published as of February 15, 2010. Electronic articles published ahead of print were also considered. Search was limited to the English language. Search was conducted using the following keywords: renal cell carcinoma, molecular, tissue, markers, blood, urine, progression, prognosis, risk factor, and survival. Studies were selected according to the relevance of the study, the number of patients included, originality, actuality, and clinical applicability of the results.
  
  
  RESULTS
  Four areas of prediction were examined: (1) new RCC diagnostics, (2) RCC grade and stage at diagnosis, (3) disease progression, and (4) disease-specific mortality. All identified reports represented either case series or controlled studies. Although a large number of markers were identified, only a few were validated. Several prognostic factors were integrated in predictive or prognostic models.
  
  
  CONCLUSIONS
  Several prognostic factors can help discriminate between favourable and unfavourable RCC phenotypes. Of those, several clinical, pathologic, and biologic markers have been tested and validated, and they are used in predictive and prognostic models. Nonetheless, the search continues, especially for informative markers predicting the response to targeted therapies.
authors: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC, Canada.
authors: Maxine
authors: M
authors: Sun
authors: Shahrokh F
authors: SF
authors: Shariat
authors: Christopher
authors: C
authors: Cheng
authors: Vincenzo
authors: V
authors: Ficarra
authors: Masaru
authors: M
authors: Murai
authors: Stéphane
authors: S
authors: Oudard
authors: Allan J
authors: AJ
authors: Pantuck
authors: Richard
authors: R
authors: Zigeuner
authors: Pierre I
authors: PI
authors: Karakiewicz
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008954:Models, Biological; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012737:Sex Factors
chemical_list: D014408:Biomarkers, Tumor