[Prognostic factors in localized and in metastatic renal cell carcinomas]

It is useful to dispose reliable prognostic factors in Renal Cell Carcinoma (RCC) for 3 major goals: providing patient information, designing rationale follow-up algorithms and selecting patients for adapted treatment schedules as well as new clinical trials. Prognostic factors in RCC include: anatomical (TNM classification), histological (Fuhrman grade and histological subtype), clinical (symptoms and performance status) and molecular factors. For improving predicative accuracy of prognostic systems such as the TNM classification, new prognostic algorithms or nomograms have been designed combining independent prognostic variables. UISS and SSIGN are the 2 most effective prognostic systems within localized RCC. In metastatic disease, the two main systems that have been used for predicting response to immunotherapy are the model of the French Group of Immunotherapy and the Motzer model. Finally, there is an increasing interest in combining molecular variables with previously established models. These new systems will require further validation as part of large prospective clinical trials.