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Prognostic Markers in Renal Cell Carcinoma: Background and Potential Utility

Nicholas G Cost, MD and Vitaly Margulis, MD

Renal cell carcinoma (RCC) comprises 3% of all adult malignancies and there are approximately 60000 new diagnoses annually in the US. However, the natural history of RCC is extremely variable [1]. Whereas some patients will present with localized disease amenable to curative resection, approximately 30% will harbor metastatic disease that is incurable with currently available treatments [2–4]. Additionally, 25–30% of patients will progress to metastatic disease after nephrectomy for what was presumed to be localized disease [5]. Although the conventional indicators of disease progression, such as tumor stage and grade, are apparent at the time of diagnosis using modern imaging and pathology, there is clearly an inherent variation in tumor biology that is not captured by these metrics.

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