Clinical Considerations on the Perspectives in Renal Tumour Molecular Pathology

Objectives: At present, clinical staging alone is not entirely accurate for predicting prognosis and selecting patients at risk for recurrence and metastasis, both of which have an impact on planning and providing additional adjuvant therapy. Many tumour markers have been studied, but no effective markers are currently available for the diagnosis and prognostication of renal cell carcinoma (RCC). Methods: We review the most recent molecular markers based on an online PubMed search. Terms for the search included renal cell carcinoma, molecular pathology, molecular analysis, molecular markers, and molecular mechanism. Results: The three major fields in the research on RCC are early diagnosis, prognostication, and therapy. Different methods for early diagnosis have been proposed, such as microsatellite analysis, methylation-specific polymerase chain reaction, and surface-enhanced laser desorption/ionisation mass spectrometry (SELDI-MS). Several markers have been suggested for prognostication, but they have not yet been evaluated sufficiently to recommend their inclusion in a clinical assay. New therapeutic approaches have been proposed to improve the treatment of patients resistant to immunotherapy. Conclusions: Many articles have been published on RCC. Most of them are devoted to the recognition of new tumour markers for therapy selection, diagnosis, and prognostication. Despite this vast effort, tumour markers for RCC still have not been validated clinically in prospective studies. © 2006 European Association of Urology.