Blair BM, et al. - Whether the American College of Surgeons NSQIP Surgical Risk Calculator can provide an accurate prediction of risk-adjusted 30-day outcomes for patients undergoing partial nephrectomy (PN) for renal cell carcinoma (RCC), was investigated by analyzing a single institution, multi-surgeon, prospectively maintained database for patients undergoing PN for RCC from 1998 to 2015. Among observed and predicted outcomes, significant discrepancies were shown by the ACS NSQIP Surgical Risk Calculator. Regardless of surgical approach, these differences remained significant, as corroborated in additional analyses. In this complex patient population, for better prediction of surgical outcomes, the requirement for urologic oncology-specific calculators was highlighted.