Dear Editor,

I read with interest the review of Tobias Klatte et al. about the prognostic factors and models for renal cell carcinoma, recently published on World Journal of Urology [1].

I noted that among the prognostic models for clinically localized disease reported in this article, a new score [called GRade, Age, Nodes and Tumor (GRANT), Table 1], recently developed and validated on ASSURE trial population, is missing [1, 2]. The performance of the GRANT score is similar to that of the UISS modified model [3], but its strength, compared with the others already available, is the ease and clarity of its calculation, with a potential role in the clinical practice [2]. Moreover, the GRANT score is validated also in non clear cell histology [2]. Last, it is the only model that included the age of the patients and it was originally developed in an adjuvant trial of immunotherapy with cytokines [4]: these considerations could candidate this score also as a useful tool as stratifying factor in the future adjuvant immunotherapy trials.

Table 1 The GRANT score: the number of unfavorable risk factors is summed, and patients with 0 or 1 factor are classified in the favorable risk group, while patients with 2 or more risk factors are classified in the unfavorable risk group
Full size table