In summary, we identified DEGs in aggressive early-stage ccRCC, defined as those with synchronous metastasis, recurrence, or cancer-specific death, and found that MOCOS, RGPD8, BAIAP2L1, and DDX11 showed significantly higher expression levels, whereas SLC16A9, FRAS1, AQP1, TMEM38B, and PRUNE2 showed significantly lower expression levels compared to those in non-aggressive ccRCC. This evidence concerns the gene TMEM38B and cancer.