biostudies-literatureUnknown17(2)Bhat P<b>Background/Objectives:</b> Predicting the behavior of clear cell renal cell carcinoma (ccRCC) is challenging using standard-of-care histopathologic examination. Indeed, pathologic RCC tumor grading, based on nuclear morphology, performs poorly in predicting outcomes of patients with International Society of Urological Pathology/World Health Organization grade 2 and 3 tumors, which account for most ccRCCs. <b>Methods:</b> We applied spatial point process modeling of H&E-stained images of patients with grade 2 and grade 3 ccRCCs (<i>n</i> = 72) to find optimum separation into two groups. <b>Results:</b> One group was associated with greater spatial randomness and clinical metastasis (<i>p</i> < 0.01). Notably, spatial analysis outperformed standard pathologic grading in predicting clinicaCancers249https://www.ebi.ac.uk/biostudies/studies/S-EPMC11763402biostudies-literatureSpatial Distribution of Tumor Cells in Clear Cell Renal Cell Carcinoma Is Associated with Metastasis and a Matrisome Gene Expression Signature.PMC11763402Sircar KKannan KTamboli PBhat PfalseSpatial Distribution of Tumor Cells in Clear Cell Renal Cell Carcinoma Is Associated with Metastasis and a Matrisome Gene Expression Signature.<b>Background/Objectives:</b> Predicting the behavior of clear cell renal cell carcinoma (ccRCC) is challenging using standard-of-care histopathologic examination. Indeed, pathologic RCC tumor grading, based on nuclear morphology, performs poorly in predicting outcomes of patients with International Society of Urological Pathology/World Health Organization grade 2 and 3 tumors, which account for most ccRCCs. <b>Methods:</b> We applied spatial point process modeling of H&E-stained images of patients with grade 2 and grade 3 ccRCCs (<i>n</i> = 72) to find optimum separation into two groups. <b>Results:</b> One group was associated with greater spatial randomness and clinical metastasis (<i>p</i> < 0.01). Notably, spatial analysis outperformed standard pathologic grading in predicting clinica2025-01-01T00:00:00Z2025 Jan2025-04-18T14:27:48.946Z2025-04-07T00:38:04.351ZS-EPMC117634023985803110.3390/cancers17020249