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Surgical intervention for residual localized disease after ICI therapy may contribute to complete disease eradication and improved outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated the clinical significance of medical CR (complete radiologic disappearance of all target lesions with ICI therapy) and surgical CR (radiographic CR after local surgery following ICI-based therapy) for patients with mRCC treated with ICI-based combination therapy. Patients were categorized into the IOIO (dual ICI therapy) and IOTKI (ICI\u2009+\u2009tyrosine kinase inhibitor therapy) groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 250 study patients, 107 and 143 received IOIO and IOTKI, respectively. The overall medical objective response and medical CR rates were 55.6% and 10.4%, respectively. Surgical CR and medical CR were achieved in 16.4% and 26.8% of individuals, respectively. Patients who achieved both medical CR and surgical CR experienced similarly favorable progression-free survival and overall survival (OS). Among those who achieved either surgical CR or medical CR, OS was longer in the IOIO group; however, no other significant intergroup differences were observed. Patients with primary tumors exhibited higher medical CR rates. No significant differences in treatment-related adverse events, treatment discontinuation, or steroid use between the medical CR and medical non-CR groups were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Approximately 25% of patients with mRCC achieved medical CR with ICI-based combination therapy. Treatment efficacy was comparable between the two regimen groups. A multidisciplinary strategy may lead to complete disease eradication for select patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10147-026-02981-9","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T06:34:51Z","timestamp":1770359691000},"page":"683-694","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical evaluation of medical and surgical complete responses in metastatic renal cell carcinoma treated with immune checkpoint inhibitor combination therapy"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3834-0153","authenticated-orcid":false,"given":"Kazuhiko","family":"Yoshida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsunenori","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junpei","family":"Iizuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Kobari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ishihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironori","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Shimmura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasunobu","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"2981_CR1","doi-asserted-by":"publisher","unstructured":"Flanigan RC, Salmon SE, Blumenstein BA et al. 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Toshio Takagi received honoraria from Bristol-Myers Squibb and Ono Pharmaceuticals.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The requirement for obtaining informed consent from participants was waived owing to the retrospective nature of this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publication"}},{"value":"All the procedures involving human participants were performed in accordance with ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. 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