Diagnosis and prognosis of renal cell carcinoma: highlights from an international consensus workshop

An International Consensus Conference reviewed the current state of histologic classification of renal cell carcinoma, grading, TNM staging, current and future prognostic factors, and clinical research priorities. International agreement was reached on the histologic classification of renal cortical epithelial neoplasms. Grading of renal cell carcinoma was recognized as subjective; nuclear grading was preferred, but the optimal system has not yet been described or tested. Current methods of staging for renal cell carcinoma have evolved and merit attention for future changes; new standards for 1997 have been reported by the American Joint Committee on Cancer and the Union International Contre le Cancer (UICC). Prognostic factors are stratified according to their utility prior to treatment, after nephrectomy, and in the presence of recurrent or metastatic cancer. New and pending prognostic factors merit serious consideration for further investigation, with emphasis on practical relevance. Future research priorities include a multitude of new targets for intervention recognized by molecular biology, as well as chemoprevention, immunotherapy, gene therapy, and vaccine therapy.