Huang Z, et al. - Researchers sought to describe clinical, pathological and outcome characteristics of clear cell renal cell carcinoma bone metastasis (ccRCC-BM). Further, they offer recommendations for a prognosis prediction system more suitable for ccRCC-BM. They analyzed a series of 106 ccRCC-BM patients with a 4:1 male predominance; 44.3% of them had synchronous bone metastasis and 28.3% had multi-organ metastasis. Observations revealed the consistently poor outcome of ccRCC-BM in unfavorable risk stratification. The prognosis could be improved in selected patients with bone lesions resection with systematic therapy. They suggest integration of shorter time to bone metastasis, elderly age, concomitant multi-organ metastasis and the expression loss of carbonic anhydrase -IX along with gender-bias, and feasibility for surgical treatment into a modified ccRCC-BM-specific prognosis prediction system.