Purpose: Hepatocyte growth factor receptor (HGFR/c-Met) signaling is associated with tumor progression in various cancers. The clinical significance and pathologic roles of phosphorylated HGFR/c-Met in renal cell carcinoma (RCC) are not fully understood; therefore, this study sought to clarify the possible role of two tyrosine residues (pY1234/pY1235 and pY1349) in HGFR/c-Met. Experimental Design: The kinetics of tyrosine phosphorylation at these two residues was examined in a human renal carcinoma cell line, ACHN cells. In addition, phosphorylated HGFR/ c-Met expression (using phosphorylation site-specific antibodies for pY1234/pY1235 and pY1349) was examined in 114 tumor sections of conventional RCC patients by immunohistochemistry. The relationships between these expressions and clinicopathologic features and survival were also investigated. Results: Although phosphorylation of Y1349 HGFR/c-Met was observed for 120 minutes after HGF treatment of ACHN cells, maximal phosphorylation of Y1234/Y1235 was observed at 30 minutes followed by a rapid inactivation. Median rates (range) of cancer cells immunopositive for pY1234/pY1235 HGFR/c-Met and pY1349 HGFR/c-Met in the tumor sections were 0% (0-5.2%) and 14.3% (0-64.3%), respectively. Positive expression of pY1349 HGFR/c-Met was significantly associated with high pT stage, presence of metastasis, and high-grade carcinoma. Multivariate Cox analysis revealed that the positive expression of pY1349 HGFR/c-Met was a significant and an independent predictor of cause-specific survival (odds ratio, 2.94; 95% confidence interval, 1.12-7.72; P = 0.028). Conclusions: Phosphorylated HGFR/c-Met may be important in the tumor progression of RCC. Expression of pY1349 HGFR/c-Met is a useful predictor for metastasis and survival of conventional RCC patients.Hepatocyte growth factor receptor (HGFR)/c-Met belongs to the tyrosine kinase receptor family of proteins and signals via HGFR/c-Met in a variety of normal cellular processes (1, 2). In addition to normal physiologic functions, HGFR/c-Met signaling is also implicated in oncogenic processes and malignant aggressiveness, such as tumor growth, invasion, and metastasis (3 -6). Down-regulation of HGFR/c-Met by small interfering RNA or inhibition of its receptor tyrosine kinase by smallmolecule inhibitors significantly inhibited proliferation and survival of tumor cells in vitro as well as tumor growth (7 -10).Furthermore, increased cellular levels of HGFR/c-Met have been correlated with tumor progression and patient outcome in various cancers (11 -13).Renal cell carcinoma (RCC) is a heterogeneous disease with several distinct genetic backgrounds (14). Most of these tumors can be classified as conventional RCC and are frequently associated with mutations of the VHL tumor suppressor gene. Activating mutations of HGFR/c-Met have been reported in hereditary type 1 papillary carcinoma (4). Although the same mutation is uncommon in sporadic papillary RCC and is not a typical feature of sporadic conventional RCC, overexpression of H...