Background: Clinical risk factors continue to separate mRCC patient survival outcomes regardless of therapy. Methods: International Metastatic RCC Database Consortium (IMDC) risk criteria were utilized to assess survival among 939 mRCC patients in the PROCLAIM data base, with dates of treatment from 2006 to present. 810 patients (pts) had data for all 6 IMDC criteria and are described here. Median follow-up is 23.4 months (range 0.2 – 124 mo). Patients are grouped by prior or no prior therapy, IL-2 alone, or subsequent therapy. Some patients are in two groups. Results: The majority of patients were treatment-naïve and intermediate risk. Of the 249 patients with favorable risk, the median OS is 63.3 mo and the 2-year OS is 77.6%. Of 480 patients with intermediate risk, median OS is 42.4 mo, 2-year OS 68.2%, and of 81 patients with poor risk, median OS 14 mo, 2-year OS 40.4%. Conclusions: Among mRCC pts treated with HD IL-2, all risk groups have median and 2-year survival consistent with or better than recent reports of checkpoint or targeted therapies for RCC. Favorable and intermediate risk (by IMDC) patients treated with HD IL-2 have better OS compared with that of poor risk patients, with highest OS in favorable risk patients. Favorable risk patients treated with HD IL-2 alone have a 2-yr OS of 74%. These data continue to support a recommendation for HD IL-2 for patients with mRCC.