AIM: The aim of our study was to assess the value of several prognostic factors for patients with clear cell renal carcinoma without distant metastases (M0) who underwent surgery in our Department from 1980 to 2010. MATERIAL OF STUDY: We analysed 131 consecutive patients with clear cell renal carcinoma who had nephrectomy and extended lymph node dissection from 1980 to 2010 were reviewed. Free from cancer survivals were correlated to several prognostic factors including preoperative blood cell count, tumour cellular differentiation and stage of the disease. RESULTS: In our study we confirmed the importance of the stage of the tumour, in particular of the T, as prognostic factor. Survival was strictly correlated to the stage of the disease: 10 year cancer free survival was 100% in patients with T1, 83% in patients with T2 N0 and 34% for patients with T3N0. No improvement of results was noted in the last years, due to unchanged proportion of early diagnosis. DISCUSSION: Long term survival after surgery for clear cell renal carcinoma depends mainly on the histology type of the tumour and on the stage of the disease. Renal carcinoma does not respond to radio and standard chemotherapy and surgery represents the only effective cure. CONCLUSION: Surgery at earlier stages is essential to improve results in patients with renal carcinoma. Earlier diagnosis at the present time is the best possibility to improve results, with the need for extensive use of screening ultrasound test.