The Fuhrman grade, like most other predictors for clear cell RCC prognosis, has not been prospectively tested and validated. However retrospective findings across studies are fairly consistent and Fuhrman grade is now a necessary component of some other scoring systems. The numerical survival estimates, it should be noted, are likely to be different in patients receiving targeted modern therapy.
We are unaware of validated management algorithms using the score.
The Fuhrman grade is not known to be accurate for individual survival prediction and should be considered a general guide rather than a reliable predictor. Consistency in pathological grading is critical.