{
  "abstract": "Objectives\n\nPerioperative immunotherapy has become the standard of care in patients with high-risk muscle-invasive urothelial carcinoma (MIUC). This study aimed to clarify oncological outcomes and safety profiles of adjuvant nivolumab therapy in MIUC, focusing on upper tract urothelial carcinoma (UTUC).Methods\n\nThis multicenter study comprised 97 patients undergoing removal of primary tumors, followed by adjuvant nivolumab therapy with a potential follow-up period ≥ 12 months. Patients were divided according to the primary tumor location: bladder cancer (BC), n = 66 (68%); UTUC, n = 31 (32%). Multivariable Cox regression analyses were applied to identify prognostic factors for disease-free survival (DFS).Results\n\nBefore surgery, 38% of patients had an estimated glomerular filtration rate (eGFR) < 50 mL/min/1.73m², but this proportion increased to 57% at nivolumab initiation with 19% of UTUC having eGFR < 30. The overall DFS at 6 months was 61.5%. DFS did not differ significantly between BC and UTUC (p = 0.83). On multivariable analyses, a higher absolute eosinophil count was significantly associated with worse DFS (HR 2.24; 95% CI, 1.24-4.03, p = 0.007), while primary tumor location was not. Immune-related adverse events (irAEs) of adrenal insufficiency and hypophysitis occurred in 8% and 4% of patients, respectively, with grade ≥ 3 occurring at 3.3-18.3 months.Conclusions\n\nAdjuvant nivolumab therapy may provide comparable oncological outcomes between BC and UTUC. Baseline eosinophil count was an independent prognosticator for DFS. The incidences of adrenal insufficiency and hypophysitis appeared higher in our real-world data. Clinicians should recognize these irAEs due to nonspecific symptoms and considerable variability in time of onset.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.",
    "Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.",
    "Department of Urology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.",
    "Department of Urology, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan.",
    "Department of Urology, Shimane University Hospital, Shimane, Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 20,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Satoshi Katayama",
      "orcid": "0000-0002-8377-2457"
    },
    {
      "affs": [
        0
      ],
      "name": "Tatsushi Kawada",
      "orcid": "0000-0002-8369-9712"
    },
    {
      "affs": [
        1
      ],
      "name": "Keiichiro Mori",
      "orcid": "0000-0002-6147-6569"
    },
    {
      "affs": [
        1
      ],
      "name": "Kosuke Iwatani"
    },
    {
      "affs": [
        0
      ],
      "name": "Shota Inoue",
      "orcid": "0009-0001-2104-0058"
    },
    {
      "affs": [
        0
      ],
      "name": "Tomofumi Watanabe",
      "orcid": "0000-0003-4759-7871"
    },
    {
      "affs": [
        0
      ],
      "name": "Ichiro Tsuboi",
      "orcid": "0000-0002-3135-8262"
    },
    {
      "affs": [
        0
      ],
      "name": "Tomoaki Yamanoi",
      "orcid": "0009-0006-9821-9407"
    },
    {
      "affs": [
        0
      ],
      "name": "Takehiro Iwata",
      "orcid": "0000-0001-6116-543X"
    },
    {
      "affs": [
        0
      ],
      "name": "Kazuma Tsuboi",
      "orcid": "0009-0000-0926-1897"
    },
    {
      "affs": [
        2
      ],
      "name": "Wataru Murao"
    },
    {
      "affs": [
        3
      ],
      "name": "Tetsuya Nakada"
    },
    {
      "affs": [
        4
      ],
      "name": "Kohei Ogawa",
      "orcid": "0000-0002-0924-2669"
    },
    {
      "affs": [
        1
      ],
      "name": "Akihiro Matsukawa",
      "orcid": "0000-0002-3324-762X"
    },
    {
      "affs": [
        1
      ],
      "name": "Takafumi Yanagisawa",
      "orcid": "0000-0002-7410-0712"
    },
    {
      "affs": [
        0
      ],
      "name": "Shingo Nishimura",
      "orcid": "0009-0009-6793-7416"
    },
    {
      "affs": [
        0
      ],
      "name": "Kensuke Bekku",
      "orcid": "0000-0003-0002-1592"
    },
    {
      "affs": [
        4
      ],
      "name": "Koichiro Wada",
      "orcid": "0000-0001-8316-2192"
    },
    {
      "affs": [
        1
      ],
      "name": "Takahiro Kimura",
      "orcid": "0000-0002-5673-1553"
    },
    {
      "affs": [
        0
      ],
      "name": "Motoo Araki",
      "orcid": "0000-0002-3172-2482"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fge034eq989ff.bib",
  "cited_by": 1,
  "doi": "10.1111/iju.70664",
  "fulltext_url": "https://europepmc.org/articles/PMC13680791",
  "id": "fge034eq989ff",
  "issns": [
    "0919-8172",
    "1442-2042"
  ],
  "landing_url": "https://europepmc.org/article/MED/42897807",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Bladder and Urothelial Cancer Treatments"
    ]
  ],
  "openalex": "W7223025862",
  "pdf_url": "https://europepmc.org/articles/PMC13680791?pdf=render",
  "pmcid": "PMC13680791",
  "pmid": "42897807",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fge034eq989ff.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42897807",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42897807"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Bladder and Urothelial Cancer Treatments",
      "subfield": "surgery"
    }
  ],
  "title": "Oncological Outcomes and Safety Profiles of Adjuvant Nivolumab in Muscle-Invasive Urothelial Carcinoma.",
  "title_text": "Oncological Outcomes and Safety Profiles of Adjuvant Nivolumab in Muscle-Invasive Urothelial Carcinoma.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:37Z",
  "url": "https://research.draconitic.com/paper/fge034eq989ff",
  "venue": "International journal of urology : official journal of the Japanese Urological Association",
  "versions": []
}