Stage	Histology	RFS or EFS	OS	Treatment (see Table 1 for chemotherapy regimen definitions)
Stage I [1-3]	FH	92% RFS	98%	Nephrectomy + lymph node sampling followed by regimen EE-4A
	FA or DA	69% EFS	83%	Nephrectomy + lymph node sampling followed by regimen EE-4A and XRT
Stage II [1,2,4]	FH	85% RFS	96%	Nephrectomy + lymph node sampling followed by regimen EE-4A
	FA (very small numbers)	80% EFS	80%	Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A
	DA	83% EFS	82%	Nephrectomy + lymph node sampling followed by abdominal XRT and regimen I
Stage III [1,2]	FH	90% RFS	95%	Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A
	FA	88% RFS	100%	Nephrectomy + lymph node sampling followed by abdominal XRT and regimen DD-4A
	FA	71% RFS	71%	Preoperative treatment with regimen DD-4A followed by nephrectomy + lymph node sampling and abdominal XRT
	DA	46% EFS	53%	Preoperative treatment with regimen I followed by nephrectomy + lymph node sampling and abdominal XRT
	DA	65% EFS	67%	Immediate nephrectomy + lymph node sampling followed by abdominal XRT and regimen I
Stage IV [1,2,4]	FH	80% RFS	90%	Nephrectomy + lymph node sampling, followed by abdominal XRT,a bilateral pulmonary XRT,b and regimen DD-4A
	FA	61% EFS	72%	Nephrectomy + lymph node sampling, followed by abdominal XRT,a bilateral pulmonary XRT,b and regimen DD-4A
	DA	33% EFS	33%	Immediate nephrectomy + lymph node sampling followed by abdominal XRT,a whole-lung XRT,a and regimen I
	DA	31% EFS	44%	Preoperative treatment with regimen I followed by nephrectomy + lymph node sampling, followed by abdominal XRT,a and whole-lung XRTb
Stage V [1,5-13]	FH	65%	78% (10 year OS)	Bilateral renal biopsies and staging of each kidney followed by preoperative treatment with regimen EE-4A (if disease in both kidneys ≤ stage II) or regimen DD-4A (if disease in both kidneys > stage II), followed by second look surgery and possibly more chemotherapy and/ or XRT
	AH	44%	55%	Bilateral renal biopsies and staging of each kidney followed by preoperative treatment with regimen I, followed by second look surgery and possibly more chemotherapy and/ or XRT
AH = anaplastic histology; DA = diffuse anaplastic; EFS = event-free survival; FA = focal anaplastic; FH = favorable histology; OS = overall survival; RFS = relapse-free survival; XRT = flank radiation therapy
aAbdominal XRT is planned according to local stage of renal tumor.
bPulmonary XRT is reserved for patients with chest x-ray evidence of pulmonary metastases.

References

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