Preoperative predictive tools may be useful in risk stratification of cancer patients and may assist in treatment decision making. In renal cell carcinoma, several preoperative predictors were developed based on clinical and imaging characteristics prior to nephrectomy. These predictive tools may identify patients which are at high risk for adverse pathologic and oncologic outcomes and suitable for inclusion in neoadjuvant trials,1 or low risk for adverse outcomes which may be more suited for active surveillance instead of surgical treatment.2