The identification of prognostic factors in patients with metastatic renal cell carcinoma represents an area of increasing interest. Multiple publications identifying pertinent clinical and laboratory variables have appeared since 1986. The current study of 353 patients with advanced disease treated at The Cleveland Clinic from 1987 to 2002 was conducted to additionally assess and validate a model proposed recently by investigators from Memorial Sloan-Kettering Cancer Center. The data presented are similar to those reported previously, which demonstrated that patients with metastatic renal cell carcinoma can be categorized into good-, intermediate-, and poor-risk groups, using readily available clinical factors. Additionally, comparability of patients in this database to a group treated recently in France was assessed. These two groups appear similar in their distribution of various clinical factors and survival. Finally, a group of international investigators has been developed to provide a comprehensive database of >4,000 patients with metastatic renal cell carcinoma to provide and validate a single model that can be used to predict survival. This project is now under way.