{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:57:05Z","timestamp":1790582225297,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Prognostic stratification remains challenging in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors. The Lung Immune Prognostic Index (LIPI) may better reflect immunotherapy\u2010related outcomes in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 120 patients with mRCC who received second\u2010line nivolumab after progression on prior tyrosine kinase inhibitor therapy. LIPI was calculated using lactate dehydrogenase (LDH) and derived neutrophil\u2010to\u2010lymphocyte ratio (dNLR), and patients were categorized into good, intermediate, and poor risk groups. Overall survival (OS) was estimated using the Kaplan\u2013Meier method and compared with the log\u2010rank test. Prognostic performance was assessed using log\u2010rank Chi\u2010squared statistics and the concordance index (C\u2010index). Cox regression analyses were performed to identify independent prognostic factors for OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Kaplan\u2013Meier analyses demonstrated the most distinct survival separation for LIPI compared with MSKCC and IMDC risk models. Log\u2010rank Chi\u2010squared values were approximately 24 for LIPI, 16 for MSKCC, and 6.6 for IMDC. Concordance analysis confirmed superior prognostic discrimination with LIPI (C\u2010index 0.639) compared with MSKCC (0.618) and IMDC (0.555). In multivariate analysis, ECOG performance status 2 (HR 4.18, 95% CI 1.62\u201310.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), absence of diabetes mellitus (HR 0.45, 95% CI 0.25\u20130.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), absence of prior nephrectomy (HR 1.93, 95% CI 1.10\u20133.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021), and absence of brain metastases (HR 0.47, 95% CI 0.23\u20130.95;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036) were independently associated with OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In mRCC patients treated with second\u2010line nivolumab, LIPI provided superior discrimination for OS compared with established risk models, supporting its clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70619","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:47:28Z","timestamp":1787809648000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of the Lung Immune Prognostic Index in Metastatic Renal Cell Carcinoma Treated With Second\u2010Line Immunotherapy"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9030-022X","authenticated-orcid":false,"given":"U\u011fur","family":"\u00d6zberk","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Ankara City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perihan","family":"Perkin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Ankara City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0130-7111","authenticated-orcid":false,"given":"Berkay","family":"Ye\u015filyurt","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Ankara City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8917-9267","authenticated-orcid":false,"given":"Efnan","family":"Alg\u0131n","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Ankara City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilal","family":"Karaka\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Ankara City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7575-9925","authenticated-orcid":false,"given":"B\u00fclent","family":"Ak\u0131nc\u0131","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Ankara City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7649-1075","authenticated-orcid":false,"given":"G\u00f6khan","family":"U\u00e7ar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Ankara City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.08.036"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.12848"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16061209"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.4809"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.06.132"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/17588359211019642"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-018-0383-1"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.4771"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/030089169408000612"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000086829.74971.4a"},{"key":"e_1_2_12_13_1","volume-title":"Impact of Comorbidity Burden on Renal Cell Carcinoma Prognosis: A Danish Nationwide Cohort Study","author":"Horsb\u00f8ll T. 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