The current status and controversy of the treatment for renal cell carcinoma are reported. From 1980 to 1990, a total of 283 patients with renal cell carcinoma were treated in Nara Medical University and its affiliated hospitals. All patients were divided into two groups: M0 group (n = 217) and M1 group (n = 66). In addition, the M0 group patients were divided into two groups according to the followup study: M0-->M0 group (n = 194) and M0-->M1 group (n = 23). There was a significant difference between the survival of the M0 group and that of the M1 group (p < 0.001). A significant difference was also seen between the survival of M0-->M0 group and that of the M0-->M1 group (p < 0.001). The clinical and pathological factors which might be related to prognosis were analyzed. In the M1 group, high stage, high grade, non-surgical treatment for primary site and metastatic sites other than the lungs were found to be poor prognostic factors. In the M0-->M1 group, no prognostic factor was seen. These findings indicated that surgical treatment for the primary site in M1 patients should be performed. In addition, development of effective treatment for metastatic sites other than the lungs and effective postoperative adjuvant treatment would be necessary.