**7. Prognosis**

ACD-associated RCC patients appearto show relatively good prognosis because of a low incidence of advanced disease [26]. In ACD-associated RCC patients treated with RN, asymptomatic patients diagnosed on screening show more favorable prognosis than sympto‐ matic patients [30]. Ishikawa et al. reported the actual five year survival rate was 79. 7% and cancer-specific survival rate was 91. 7% for surgically treated 662 cases of ESRD-associated RCC [93]. Neuzillet et al. reported that ESRD-associated RCC seems to exhibit many favorable clinicopathologic features and prognosis compared with conventional RCC [28]. Shrewsberry et al. reported that there was no difference in overall or cancer specific mortality between nonmetastatic RCC patients with ESRD and those without ESRD when the patients underwent RN [94]. Several cases of ACD-associated RCC with sarcomatoid change [10] and rhabdoid features [95] have been reported to behave in an aggressive fashion.
