Valosin-Containing Protein (VCP)/p97 Expression Correlation of Prognosis of Clear Cell Renal Cell Carcinomas

Background/Objectives: Although certain established prognostic factors may occasionally fail to provide precise risk prediction in renal cell carcinoma (RCC), valosin-containing protein (VCP)/p97 has been implicated in a poor prognosis in various cancers, while its prognostic value in clear cell renal cell carcinoma (ccRCC) remains unknown. This study aimed to determine the independent prognostic value of VCP/p97 expression in ccRCC. Methods: This retrospective study included 137 ccRCC patients, and VCP/p97 expression was analyzed by immunohistochemistry and classified into either low or high expression based on the intensity of the staining in relation to the expression in endothelial cells. Results: High expression of VCP/p97 was significantly correlated with large tumor size (p < 0.001), Fuhrman nuclear grade (p = 0.003), advanced TNM stage (p < 0.001), and distant metastasis (p < 0.001). Kaplan-Meier analysis showed that the survival of patients with high expression of VCP/p97 was significantly reduced, and multivariate analysis revealed that high expression of VCP/p97 independently predicted poor survival (HR 2.09, 95% CI 1.06-4.15, p = 0.034) in addition to age, Fuhrman grade, and TNM stage. Conclusions: This study demonstrated that VCP/p97 expression, a newly identified prognostic factor, independently predicted a poor prognosis in ccRCC, and its expression may be a useful tool in identifying ccRCC patients with a poor prognosis.