{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:06:32Z","timestamp":1753862792856,"version":"3.41.2"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010014","name":"Six Talent Peaks Project in Jiangsu Province","doi-asserted-by":"publisher","award":["WSW\u2010064"],"award-info":[{"award-number":["WSW\u2010064"]}],"id":[{"id":"10.13039\/501100010014","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>For patients with bladder cancer (BC) undergoing radical cystectomy followed by adjuvant chemotherapy, the impact of visceral adipose tissue on prognosis and chemotherapy\u2010related toxicities has not been well established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>From July 2013 to November 2020, 224 BC patients received adjuvant gemcitabine plus cisplatin at our institution. Computed tomography images of the patients were analyzed to calculate the visceral adipose tissue index (VATI). Patients were stratified into high\u2010 and low\u2010VATI groups based on a predetermined cutoff value, and differences in prognosis and chemotherapy\u2010related adverse events (AEs) between the two groups were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After propensity score matching, a total of 166 patients were enrolled, with 83 in the low\u2010VATI group and 83 in the high\u2010VATI group. The low\u2010VATI group exhibited notably extended progression\u2010free survival (PFS) in comparison to the high\u2010VATI group (<jats:italic>p<\/jats:italic>\u2009=\u20090.044). Conversely, no substantial variation was noted concerning overall survival (OS) among the patient cohorts. In the multivariable Cox regression analysis, patients aged over 70\u2009years (HR\u2009=\u20091.66, 95% CI 1.09\u20132.57, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) and nodal positivity (HR\u2009=\u20092.98, 95% CI 1.04\u20134.28, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) emerged as significant risk factors for OS. In addition to the level of VATI (HR\u2009=\u20092.47, 95% CI 1.02\u20134.21, <jats:italic>p<\/jats:italic>\u2009=\u20090.04), nodal positivity (HR\u2009=\u20094.04, 95% CI 1.30\u201312.56, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) remained a significant risk factor for PFS. Regarding chemotherapy\u2010related AEs, the most common AEs of any grade and grade \u2265\u20093 were hematologic toxicities. Patients in the low\u2010VATI group exhibited a higher likelihood of experiencing grade \u2265\u20093 neutropenia compared to those in the high\u2010VATI group (<jats:italic>p<\/jats:italic>\u2009=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrated that, among patients treated with adjuvant chemotherapy for locally advanced BC, patients in the low\u2010VATI group exhibited a significantly prolonged PFS compared to those in the high\u2010VATI group. However, no significant difference was observed in terms of OS. Regarding chemotherapy\u2010related AEs, patients in the high\u2010VATI group exhibited a relatively lower incidence and severity of toxic reactions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70742","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T03:44:55Z","timestamp":1743306295000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Visceral Adipose Predicts Prognosis and Toxicities in Locally Advanced Bladder Cancer Patients Treated With Adjuvant Gemcitabine Plus Cisplatin Chemotherapy"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6394-287X","authenticated-orcid":false,"given":"Zhimin","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Urology The Affiliated Hospital of Xuzhou Medical University  Xuzhou China"},{"name":"Graduate School of Xuzhou Medical University  Xuzhou 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