{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T21:58:36Z","timestamp":1783547916609,"version":"3.55.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/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-064"],"award-info":[{"award-number":["WSW-064"]}],"id":[{"id":"10.13039\/501100010014","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Project supported by the Natural Science Foundation of the Jiangsu Higher Education Institutions of China","award":["19KJB310001"],"award-info":[{"award-number":["19KJB310001"]}]},{"name":"Post-doctoral Research Funding Project in Jiangsu Province","award":["2021K447C"],"award-info":[{"award-number":["2021K447C"]}]},{"name":"Second Round of Xuzhou Medical Leading Talents Training Project","award":["XWRCHT20210027"],"award-info":[{"award-number":["XWRCHT20210027"]}]},{"name":"The Science and Technology Planning Project of Traditional Chinese Medicine of Jiangsu","award":["YB2020050"],"award-info":[{"award-number":["YB2020050"]}]},{"name":"Practice Innovation Program of Jiangsu Province","award":["KYCX21_2641"],"award-info":[{"award-number":["KYCX21_2641"]}]},{"name":"Postgraduate Research and Practice Innovation Project of Jiangsu Province","award":["KYCX23_2926"],"award-info":[{"award-number":["KYCX23_2926"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Clin Oncol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In the era of combination therapy, there has been limited research on body composition. Specific body composition, such as sarcopenia, possesses the potential to serve as a predictive biomarker for toxic effects and clinical response in patients with urothelial carcinoma (UC) undergoing tislelizumab combined with gemcitabine and cisplatin (T\u2009+\u2009GC).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and Methods<\/jats:title>\n                <jats:p>A total of 112 UC patients who received T\u2009+\u2009GC were selected at the Affiliated Hospital of Xuzhou Medical University from April 2020 to January 2023. Baseline patient characteristics and detailed hematological parameters were collected using the electronic medical system and laboratory examinations. The computed tomography images of patients were analyzed to calculate psoas muscle mass index (PMI). We evaluated the association between sarcopenia (PMI\u2009&lt;\u20094.5 cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> in men; PMI\u2009&lt;\u20093.3 cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> in women) and both hematological toxicity and tumor response.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, of the 112 patients (65.2% male, median age 56\u00a0years), 43 (38.4%) were defined as sarcopenia. Patients with sarcopenia were notably older (<jats:italic>p<\/jats:italic>\u2009=\u20090.037), more likely to have hypertension (<jats:italic>p<\/jats:italic>\u2009=\u20090.009), and had poorer ECOG-PS (<jats:italic>p<\/jats:italic>\u2009=\u20090.027). Patients with sarcopenia were more likely to develop leukopenia (OR 2.969, 95% CI 1.028\u20138.575, <jats:italic>p<\/jats:italic>\u2009=\u20090.044) after receiving at least two cycles of T\u2009+\u2009GC. However, these significant differences were not observed in thrombocytopenia and anemia. There were no significant differences in the tumor response and grade 3\u20134 hematological toxicity between patients with sarcopenia and those without sarcopenia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Patients with sarcopenia were more likely to develop leukopenia after receiving T\u2009+\u2009GC. There were no notable alterations observed in relation to anemia or thrombocytopenia. No significant difference was found between the sarcopenia group and non-sarcopenia group in terms of tumor response and grade 3\u20134 hematological toxicity.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10147-023-02448-1","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T06:42:16Z","timestamp":1711089736000},"page":"592-601","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sarcopenia is associated with leukopenia in urothelial carcinoma patients who receive tislelizumab combined with gemcitabine and cisplatin therapy"],"prefix":"10.1007","volume":"29","author":[{"given":"Zhimin","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yubin","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zewei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junqi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienie","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"2448_CR1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/1477-7819-12-14","volume":"12","author":"F Wan","year":"2014","unstructured":"Wan F, Zhu Y, Gu C et al (2014) Lower skeletal muscle index and early complications in patients undergoing radical cystectomy for bladder cancer. World J Surg Oncol 12:14","journal-title":"World J Surg Oncol"},{"issue":"6","key":"2448_CR2","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1016\/j.juro.2013.12.047","volume":"191","author":"A Smith","year":"2014","unstructured":"Smith A, Deal A, Yu H et al (2014) Sarcopenia as a predictor of complications and survival following radical cystectomy. J Urol 191(6):1714\u20131720","journal-title":"J Urol"},{"issue":"18","key":"2448_CR3","doi-asserted-by":"publisher","first-page":"2910","DOI":"10.1002\/cncr.28798","volume":"120","author":"S Psutka","year":"2014","unstructured":"Psutka S, Carrasco A, Schmit G et al (2014) Sarcopenia in patients with bladder cancer undergoing radical cystectomy: impact on cancer-specific and all-cause mortality. Cancer 120(18):2910\u20132918","journal-title":"Cancer"},{"issue":"3","key":"2448_CR4","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.clgc.2015.07.015","volume":"14","author":"S Taguchi","year":"2016","unstructured":"Taguchi S, Akamatsu N, Nakagawa T et al (2016) Sarcopenia evaluated using the skeletal muscle index is a significant prognostic factor for metastatic urothelial carcinoma. Clin Genitourin Cancer 14(3):237\u2013243","journal-title":"Clin Genitourin Cancer"},{"key":"2448_CR5","doi-asserted-by":"publisher","first-page":"7981549","DOI":"10.1155\/2017\/7981549","volume":"2017","author":"R Kasahara","year":"2017","unstructured":"Kasahara R, Kawahara T, Ohtake S et al (2017) A low psoas muscle index before treatment can predict a poorer prognosis in advanced bladder cancer patients who receive gemcitabine and nedaplatin therapy. Biomed Res Int 2017:7981549","journal-title":"Biomed Res Int"},{"key":"2448_CR6","doi-asserted-by":"crossref","unstructured":"Engelmann S, Pickl C, Haas M et al (2023) Body composition of patients undergoing radical cystectomy for bladder cancer: sarcopenia, low psoas muscle index, and myosteatosis are independent risk factors for mortality. Cancers 15(6)","DOI":"10.3390\/cancers15061778"},{"key":"2448_CR7","doi-asserted-by":"crossref","unstructured":"Pickl C, Engelmann S, Girtner F et al (2023) Body composition as a comorbidity-independent predictor of survival following nephroureterectomy for urothelial cancer of the upper urinary tract. Cancers 15(2)","DOI":"10.3390\/cancers15020450"},{"key":"2448_CR8","doi-asserted-by":"crossref","unstructured":"Mitsiopoulos N, Baumgartner R, Heymsfield S et al (1998) Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol (Bethesda, MD: 1985) 85(1):115\u2013122","DOI":"10.1152\/jappl.1998.85.1.115"},{"key":"2448_CR9","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1016\/j.nut.2016.04.003","volume":"32","author":"Y Hamaguchi","year":"2016","unstructured":"Hamaguchi Y, Kaido T, Okumura S et al (2016) Proposal for new diagnostic criteria for low skeletal muscle mass based on computed tomography imaging in Asian adults. Nutrition (Burbank, Los Angeles County, Calif) 32:1200\u20131205","journal-title":"Nutrition (Burbank, Los Angeles County, Calif)"},{"issue":"3","key":"2448_CR10","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s10147-020-01833-4","volume":"26","author":"M Kano","year":"2021","unstructured":"Kano M, Hihara J, Tokumoto N et al (2021) Association between skeletal muscle loss and the response to nivolumab immunotherapy in advanced gastric cancer patients. Int J Clin Oncol 26(3):523\u2013531","journal-title":"Int J Clin Oncol"},{"issue":"3","key":"2448_CR11","doi-asserted-by":"publisher","first-page":"W221","DOI":"10.2214\/AJR.09.3928","volume":"195","author":"M Nishino","year":"2010","unstructured":"Nishino M, Jackman D, Hatabu H et al (2010) New Response Evaluation Criteria in Solid Tumors (RECIST) guidelines for advanced non-small cell lung cancer: comparison with original RECIST and impact on assessment of tumor response to targeted therapy. Am J Roentgenol 195(3):W221\u2013W228","journal-title":"Am J Roentgenol"},{"issue":"5","key":"2448_CR12","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1053\/j.seminoncol.2012.08.007","volume":"39","author":"J Bellmunt","year":"2012","unstructured":"Bellmunt J, Petrylak DP (2012) New therapeutic challenges in advanced bladder cancer. Semin Oncol 39(5):598\u2013607","journal-title":"Semin Oncol"},{"issue":"3","key":"2448_CR13","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1016\/j.eururo.2016.06.020","volume":"71","author":"J Alfred Witjes","year":"2017","unstructured":"Alfred Witjes J, Lebret T, Comp\u00e9rat E et al (2017) Updated 2016 EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol 71(3):462\u2013475","journal-title":"Eur Urol"},{"issue":"10232","key":"2448_CR14","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1016\/S0140-6736(20)30415-3","volume":"395","author":"A Birtle","year":"2020","unstructured":"Birtle A, Johnson M, Chester J et al (2020) Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial. Lancet (London, England) 395(10232):1268\u20131277","journal-title":"Lancet (London, England)"},{"issue":"8","key":"2448_CR15","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1200\/JCO.2015.64.1076","volume":"34","author":"M Galsky","year":"2016","unstructured":"Galsky M, Stensland K, Moshier E et al (2016) Effectiveness of adjuvant chemotherapy for locally advanced bladder cancer. J Clin Oncol 34(8):825\u2013832","journal-title":"J Clin Oncol"},{"issue":"9","key":"2448_CR16","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1056\/NEJMoa022148","volume":"349","author":"H Grossman","year":"2003","unstructured":"Grossman H, Natale R, Tangen C et al (2003) Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 349(9):859\u2013866","journal-title":"N Engl J Med"},{"issue":"10236","key":"2448_CR17","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1016\/S0140-6736(20)30230-0","volume":"395","author":"MD Galsky","year":"2020","unstructured":"Galsky MD, Arija J\u00c1A, Bamias A et al (2020) Atezolizumab with or without chemotherapy in metastatic urothelial cancer (IMvigor130): a multicentre, randomised, placebo-controlled phase 3 trial. Lancet 395(10236):1547\u20131557","journal-title":"Lancet"},{"issue":"11","key":"2448_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2022.100785","volume":"3","author":"J Hu","year":"2022","unstructured":"Hu J, Chen J, Ou Z et al (2022) Neoadjuvant immunotherapy, chemotherapy, and combination therapy in muscle-invasive bladder cancer: a multi-center real-world retrospective study. Cell Rep Med 3(11):100785","journal-title":"Cell Rep Med"},{"issue":"1","key":"2448_CR19","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1186\/s12894-022-01083-8","volume":"22","author":"X Ren","year":"2022","unstructured":"Ren X, Tian Y, Wang Z et al (2022) Tislelizumab in combination with gemcitabine plus cisplatin chemotherapy as first-line adjuvant treatment for locally advanced or metastatic bladder cancer: a retrospective study. BMC Urol 22(1):128","journal-title":"BMC Urol"},{"key":"2448_CR20","doi-asserted-by":"crossref","unstructured":"Fukushima H, Takemura K, Suzuki H et al (2018) Impact of sarcopenia as a prognostic biomarker of bladder cancer. Int J Mol Sci 19(10)","DOI":"10.3390\/ijms19102999"},{"issue":"11","key":"2448_CR21","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.1016\/j.dld.2019.08.017","volume":"51","author":"A Hari","year":"2019","unstructured":"Hari A, Berzigotti A, \u0160tabuc B et al (2019) Muscle psoas indices measured by ultrasound in cirrhosis\u2014preliminary evaluation of sarcopenia assessment and prediction of liver decompensation and mortality. Dig Liver Dis 51(11):1502\u20131507","journal-title":"Dig Liver Dis"},{"key":"2448_CR22","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.urology.2021.08.013","volume":"158","author":"J Stangl-Kremser","year":"2021","unstructured":"Stangl-Kremser J, Ahmadi H, Derstine B et al (2021) Psoas muscle mass can predict postsurgical outcomes in patients who undergo radical cystectomy and urinary diversion reconstruction. Urology 158:142\u2013149","journal-title":"Urology"},{"issue":"3","key":"2448_CR23","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1002\/jcsm.12279","volume":"9","author":"R Mayr","year":"2018","unstructured":"Mayr R, Gierth M, Zeman F et al (2018) Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer. J Cachexia Sarcopenia Muscle 9(3):505\u2013513","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"1","key":"2448_CR24","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s10147-021-02032-5","volume":"27","author":"R Shimizu","year":"2022","unstructured":"Shimizu R, Honda M, Teraoka S et al (2022) Sarcopenia is associated with survival in patients with urothelial carcinoma treated with systemic chemotherapy. Int J Clin Oncol 27(1):175\u2013183","journal-title":"Int J Clin Oncol"},{"key":"2448_CR25","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1245\/s10434-016-5606-4","volume":"23","author":"Y Hirasawa","year":"2016","unstructured":"Hirasawa Y, Nakashima J, Yunaiyama D et al (2016) Sarcopenia as a novel preoperative prognostic predictor for survival in patients with bladder cancer undergoing radical cystectomy. Ann Surg Oncol 23:1048\u20131054","journal-title":"Ann Surg Oncol"},{"issue":"8","key":"2448_CR26","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1007\/s00345-018-2259-x","volume":"36","author":"R Mayr","year":"2018","unstructured":"Mayr R, Fritsche H, Zeman F et al (2018) Sarcopenia predicts 90-day mortality and postoperative complications after radical cystectomy for bladder cancer. World J Urol 36(8):1201\u20131207","journal-title":"World J Urol"},{"key":"2448_CR27","doi-asserted-by":"crossref","unstructured":"Cohen S, Gal J, Freifeld Y et al (2021) Nutritional status impairment due to neoadjuvant chemotherapy predicts post-radical cystectomy complications. Nutrients 13(12)","DOI":"10.3390\/nu13124471"},{"issue":"3","key":"2448_CR28","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1038\/bjc.2016.431","volume":"116","author":"L Daly","year":"2017","unstructured":"Daly L, Power D, O\u2019Reilly \u00c1 et al (2017) The impact of body composition parameters on ipilimumab toxicity and survival in patients with metastatic melanoma. Br J Cancer 116(3):310\u2013317","journal-title":"Br J Cancer"},{"issue":"12","key":"2448_CR29","doi-asserted-by":"publisher","first-page":"5150","DOI":"10.21037\/tcr-21-1470","volume":"10","author":"S Li","year":"2021","unstructured":"Li S, Wang T, Lai W et al (2021) Prognostic impact of sarcopenia on immune-related adverse events in malignancies received immune checkpoint inhibitors: a systematic review and meta-analysis. Transl Cancer Res 10(12):5150\u20135158","journal-title":"Transl Cancer Res"},{"key":"2448_CR30","doi-asserted-by":"crossref","unstructured":"Shimizu T, Miyake M, Hori S et al (2020) Clinical impact of sarcopenia and inflammatory\/nutritional markers in patients with unresectable metastatic urothelial carcinoma treated with pembrolizumab. Diagnostics (Basel, Switzerland) 10(5)","DOI":"10.3390\/diagnostics10050310"},{"issue":"8","key":"2448_CR31","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1097\/CAD.0000000000000982","volume":"31","author":"H Fukushima","year":"2020","unstructured":"Fukushima H, Fukuda S, Moriyama S et al (2020) Impact of sarcopenia on the efficacy of pembrolizumab in patients with advanced urothelial carcinoma: a preliminary report. Anticancer Drugs 31(8):866\u2013871","journal-title":"Anticancer Drugs"},{"issue":"2","key":"2448_CR32","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1159\/000489013","volume":"101","author":"A Mari","year":"2018","unstructured":"Mari A, D\u2019Andrea D, Kimura S et al (2018) Sarcopenia as a predictive factor for response to upfront cisplatin-based chemotherapy in patients with muscle-invasive urothelial bladder cancer. Urol Int 101(2):197\u2013200","journal-title":"Urol Int"}],"container-title":["International Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10147-023-02448-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10147-023-02448-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10147-023-02448-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T03:43:22Z","timestamp":1714016602000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10147-023-02448-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,22]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["2448"],"URL":"https:\/\/doi.org\/10.1007\/s10147-023-02448-1","relation":{},"ISSN":["1341-9625","1437-7772"],"issn-type":[{"value":"1341-9625","type":"print"},{"value":"1437-7772","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,22]]},"assertion":[{"value":"27 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This retrospective single-institutional study was approved by the ethics committee of the Affiliated Hospital of Xuzhou Medical University (XYFY2022-KL340). All patients provided written informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent to publish was obtained.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}