The incorporation of B4GALT1 into T stage and Fuhrman grade would help to refine individual risk stratification. Furthermore, B4GALT1 expression was identified as an independent adverse prognostic factor for survival. A predictive nomogram was generated with identified independent prognositicators to assess patient overall survival at 5 and 10 years.CONCLUSIONS: Increased B4GALT1 expression is a potential independent adverse prognostic factor for overall survival in patients with localized ccRCC. Inhibting B4GALT1 pathway might be a promising target of postoperative adjuvant therapy for these ccRCC patients.