Several molecular and genetic markers have been investigated as potential prognostic factors for RCC: Von Hippel Lindau (VHL) gene alterations, hypoxia-induced factor 1 alpha (HIF-1a), mTOR, ribosomal protein S6 and phosphatase PTEN, Ki-67, levels of carbonic anhydrase 9 (CAIX), and matrix metalloproteinase 2 and 9 [64]. This evidence concerns the gene CA9 and renal cell adenocarcinoma.