The Authors carried out a literature review on prognostic factors and current management of renal cell carcinoma. A significant factor influencing survival appears to be the extension of the primary tumor (T). The finding of no nodal involvement is not always a favourable prognostic factor if the tumor is no more confined. A perfect knowledge of the prognostic factors may be useful to identify those patients who need post-operative chemotherapy. Surgery is still the treatment of choice for renal cell carcinoma. Extensive lymphadenectomy does not influence long-term survival, nevertheless since there is no additional mortality or morbidity, it is considered useful for a correct staging and a better evaluation of long-term prognosis.