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Importantly, IGF1R expression also determine RCC aggressiveness, while patients with clear-cell RCC shown kidney IGF1R expression higher than 50% have shorter survival time, a difference that becomes particularly significant after two years of follow-up.40 Moreover, after adjustment for age and stage at diagnosis, those patients with renal IGF1R expression higher than 50% had a 4.2 increased risk of death compared to those with lower renal IGF1R expression