The survival of patients with renal cell carcinoma is directly related to the extent of malignancy at the time of treatment. Patients with T1 and T2 disease experience excellent survival independent of the grade of the disease. However, once the disease has extended from the kidney, survival is a function of whether the disease progresses by direct extension or has the ability to move through space and deposit at distant metastatic sites. When this occurs, survival is almost directly a function of the grade and degree of malignancy of the renal tumor.