OBJECTIVE To establish the prognostic value of a series of pre-operative, per-operative and histopathological parameters in relation to renal cell carcinoma (RCC). METHODS This retrospective study involved a consecutive series of 76 patients (46 men and 30 women with a mean age of 65.3 years [range 44-91]) with a histologically confirmed diagnosis of RCC. Patients who were admitted over the period 1980-1984 were included. Data such as erythrocyte sedimentation rate (ESR), alkaline phosphatase level, histological tumour grade, degree of necrosis and presence of tumour vessels were evaluated in relation to actuarial survival. RESULTS The ESR and alkaline phosphatase level at the time of diagnosis of RCC, the histological tumour grade, degree of necrosis and presence of tumour vessels on angiography were all found to affect the actuarial length of survival significantly (P < or = 0.05 log-rank test). Macroscopic tumour demarcation estimated per-operatively by the surgeon or after surgery by the pathologist, microscopic demarcation, vascular density on histological examination, tumour diameter and vascular density on angiography were found not to affect actuarial survival significantly. CONCLUSIONS The value of establishing simple and reliable diagnostic indicators for patients with RCC is stressed.