An important step in establishing a treatment strategy for small renal masses of clear cell renal cell carcinoma based on the significance of adverse histopathologic features on tumor needle biopsy

Renal cell carcinoma (RCC) accounts for 3–4% of all adult cancer cases in the United States, and is divided into two groups: clear cell RCC (CCRCC) and non-CCRCC (1,2). CCRCC is the most dominant histological phenotype that accounts for 70–80% of all RCC cases. A total of 20–40% of patients with RCC experience metastatic or recurrent disease after a primary surgery [nephrectomy or partial nephrectomy (PN)], and approximately 50% of patients with RCC eventually receive systemic medication during their disease course (2).