{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T06:04:33Z","timestamp":1779257073296,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction and Objectives<\/jats:title><jats:p>This study assessed the prognostic value of maximal evaluable lesion size (MLS) in predicting the efficacy and outcomes of nivolumab plus ipilimumab (NIVO+IPI) therapy for metastatic renal cell carcinoma (mRCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 99 mRCC patients treated with NIVO + IPI. Patients were divided into larger\u2010MLS (\u2265\u200935\u2009mm) and smaller\u2010MLS (&lt;\u200935\u2009mm) groups based on the median MLS. Objective response rate (ORR), progression\u2010free survival (PFS), and overall survival (OS) were compared, and predictive factors for PFS and OS were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up period was 29.5\u2009months. In the larger\u2010MLS group (50 patients), the number of patients who did not undergo cytoreductive nephrectomy, as well as the number of patients in whom the kidney, lymph node, and lung were identified as an organ of MLS origin, was significantly higher compared to the smaller\u2010MLS group. ORR was 40% in the larger\u2010MLS group and 32.7% in the smaller\u2010MLS group (<jats:italic>p<\/jats:italic>\u2009=\u20090.4315). However, PFS and OS were significantly worse in the larger\u2010MLS group (<jats:italic>p<\/jats:italic>\u2009=\u20090.0016 and <jats:italic>p<\/jats:italic>\u2009=\u20090.0002, respectively). Multivariate analysis identified Karnofsky performance status (KPS) &lt;\u200980%, non\u2010clear cell histology, and larger MLS as independent predictors of worse PFS and OS. A prognostic model integrating MLS, KPS, and histology stratified patients effectively, with \u2265\u20092 risk factors predicting significantly worse OS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MLS is a key prognostic factor in mRCC patients treated with NIVO+IPI. A risk model incorporating MLS, KPS, and histology can aid in patient stratification and treatment decisions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.70065","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T15:18:32Z","timestamp":1744039112000},"page":"850-858","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic Impact of the Maximal Evaluable Lesion Size in Patients With Metastatic Renal Cell Carcinoma Treated With Nivolumab Plus Ipilimumab Combination Therapy"],"prefix":"10.1111","volume":"32","author":[{"given":"Yoshie","family":"Mita","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Teishima","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4524-2815","authenticated-orcid":false,"given":"Takuto","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7742-4528","authenticated-orcid":false,"given":"Hideto","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoto","family":"Wakita","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-3949","authenticated-orcid":false,"given":"Yasuyoshi","family":"Okamura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4589-9251","authenticated-orcid":false,"given":"Kotaro","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7736-1216","authenticated-orcid":false,"given":"Yukari","family":"Bando","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4447-6516","authenticated-orcid":false,"given":"Tomoaki","family":"Terakawa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Chiba","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideaki","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Kobe University, Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00917-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.08.019"},{"key":"e_1_2_9_4_1","first-page":"19","article-title":"NCCN Guidelines Insights: Kidney Cancer, Version 1.2021","volume":"8","author":"Motzer R. J.","year":"2021","journal-title":"Journal of the National Comprehensive Cancer Network"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14922"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816714"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2023.14057"},{"issue":"23","key":"e_1_2_9_8_1","first-page":"2203","article-title":"Nivolumab Plus Ipilimumab in Advanced Renal Cell Carcinoma","volume":"373","author":"Motzer R. J.","year":"2015","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15193"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-023-13746-3"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-020-07690-8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyab142"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-022-02215-8"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.15751"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12935-021-02299-8"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-020-01327-7"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20140559"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri3064"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aar4060"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3245"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2024.10.015"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1712126"}],"container-title":["International Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T09:25:32Z","timestamp":1751880332000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iju.70065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,7]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/iju.70065"],"URL":"https:\/\/doi.org\/10.1111\/iju.70065","archive":["Portico"],"relation":{},"ISSN":["0919-8172","1442-2042"],"issn-type":[{"value":"0919-8172","type":"print"},{"value":"1442-2042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,7]]},"assertion":[{"value":"2024-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}