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Gene signatures of pulmonary renal cell carcinoma (RCC) metastases predict metastases-free interval and number of metastases per patient Conclusion & Perspectives Mets derived from pts with different DFI or differing numbers of Mets are distinguishable based on their expression profiles further analyses will reveal, which of the identified features are already present in matched primary tumors and therefore, suitable for prognostic purposes Tab.1: Six gene signature for the differentiation between late and early Mets. {Fold changes (FC) = 2 log } Introduction and objectives patients (pts) with renal cell carcinoma (RCC) have a high risk of metastatic spread (up to 60% of the pts) urological cancer with the highest percentage of tumor-related deaths molecular basis of particular characteristics of metastatic spread, like dormancy period or number of metastases (Mets) is largely unknown molecular prognosis markers are lacking we investigated a unique tool of pulmonary Mets of clear cell RCC in order to identify expression patterns associated with two important prognostic factors in RCC: the disease-free interval after nephrectomy (DFI): early vs. late Mets and the number of (lung) Mets: multiple vs. few Mets Results II multiple vs. few Mets multiple Mets: number of Mets=16-80, median=24, n=7 few Mets: number of pulmonary Mets=1-8, median=3, n=10 135 differentially expressed genes (163 probe sets; Fig.3), 85 & 50 in few Mets biological processes: cell division (e.g. PBK, BIRC5, PTTG1) activated in multiple Mets higher number of Mets might result from an increased growth potential prediction model: 11/135 genes sufficient for prediction (KNN) correct leave-1-out cross validation (p