{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T16:52:15Z","timestamp":1769446335421,"version":"3.49.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Reliable prognostic markers for immune checkpoint inhibitor (ICI) response in metastatic renal cell carcinoma (mRCC) remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the impact of splenic volume change after ICI initiation on progression-free survival (PFS) and overall survival (OS) in patients with mRCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective cohort study reviewing data from 2015 to 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The Emory Kidney Cancer database (single-center academic instution).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with mRCC who underwent first-line ICI treatment and had available abdominal imaging 30 days before and 60-120 days after ICI initiation. A total of 109 patients met inclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Splenic volume change calculated as a percentage difference between baseline and follow-up imaging (median 2.8 months post-initiation) using a standardized formula, grouped into \u226510% increase and &amp;lt;10% increase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Differences in OS and PFS assessed using Kaplan\u2013Meier curves and multivariable Cox hazards regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 109 patients met inclusion criteria. Median follow-up time was 25.2\u2009months (IQR 11.2-41.5), during which there were 47 mortality events. Patients with a splenic volume increase \u2265 10% at a median 2.8\u2009months after ICI initiation had worse 2-year PFS (28.5% vs 50.4%, P\u2009=\u2009.022) but not OS (69.4% vs 77.8%, P\u2009=\u2009.853) compared to patients with a\u2009&amp;lt;\u200910% increase in splenic volume. On multivariable analysis, a splenic volume increase \u2265 10% was independently associated with worse PFS (2.33 [95% CI 1.37-3.96], P\u2009=\u2009.002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In patients with mRCC, a splenic volume increase \u2265 10% at a median of 2.8\u2009months following ICI initiation is independently associated with worse survival compared to an &amp;lt; 10% increase. Monitoring splenic volume changes may serve as a cost-effective radiographic prognostic marker to guide treatment sequencing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf397","type":"journal-article","created":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T12:25:28Z","timestamp":1767443128000},"source":"Crossref","is-referenced-by-count":0,"title":["An increase in splenic volume after first-line immunotherapy is associated with worse PFS in patients with metastatic renal cell carcinoma"],"prefix":"10.1093","volume":"31","author":[{"given":"Gregory","family":"Palmateer","sequence":"first","affiliation":[{"name":"Department of Urology, Emory University School of Medicine , Atlanta, GA 30322,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2542-3714","authenticated-orcid":false,"given":"Ahmet","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Department of Hematology 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