NOTCH1 and nonpapillary renal cell carcinoma: In ccRCC, high NOTCH1-ICD expression (>15% positive nuclei) identified a small subgroup of tumors with aggressive features and a trend toward poorer overall survival; however, in multivariate analysis, tumor grade emerged as the only independent prognostic factor (HR = 3.36, 95% CI: 1.07-10.49, p = 0.037), while NOTCH1 showed nonsignificant association with poorer survival (HR = 1.30, 95% CI: 0.87-1.93, p = 0.203).