{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:47:44Z","timestamp":1782452864907,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Non\u2010muscle\u2010invasive bladder cancer (NMIBC) commonly recurs despite intravesical Bacillus Calmette\u2010Gu\u00e9rin (BCG) therapy. Host factors that modify the effectiveness of BCG have not been completely defined. We evaluated whether sarcopenia is associated with outcomes after BCG in Japanese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective single\u2010center cohort study (2010\u20132023) including high\u2010grade (HG) NMIBC patients treated with BCG (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009139) and those not receiving BCG (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009100). Sarcopenia was defined a priori using sex\u2010 and BMI\u2010specific skeletal muscle index (SMI) and psoas muscle index (PMI) cutoffs derived from baseline L3 computed tomography and validated in Asian adults. The endpoints were intravesical recurrence\u2010free survival (IVRFS), high\u2010grade recurrence\u2010free survival (HGRFS), progression\u2010free survival (PFS), and overall survival (OS). Feature selection used LASSO\u2010Cox with cross\u2010validation; performance was assessed using time\u2010dependent ROC. Within the BCG cohort, we conducted a 1:1 propensity score matching.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the BCG cohort, 93\/139 (66.9%) and 69\/139 (49.6%) patients were classified as sarcopenic according to SMI and PMI, respectively. One\u2010 and two\u2010year apparent AUCs for intravesical recurrence were 0.75 and 0.79 (validation AUCs 0.68 and 0.71). Kaplan\u2013Meier analyses revealed no differences in outcomes by sarcopenia in the non\u2010BCG cohort but worse outcomes across endpoints in the BCG cohort. After matching, SMI\u2010based sarcopenia was associated with shorter IVRFS, whereas PMI\u2010based sarcopenia was associated with shorter IVRFS, HGRFS, PFS, and OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with sarcopenia were less likely to benefit from BCG. The incorporation of computed tomography\u2010based muscle indices into pre\u2010BCG decision\u2010making may improve risk stratification and supportive care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70526","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:53:13Z","timestamp":1780570393000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sarcopenia Weakens the Benefit of Bacillus Calmette\u2010Gu\u00e9rin in Non\u2010Muscle\u2010Invasive Bladder Cancer: A Computed Tomography\u2010Based Cohort Study"],"prefix":"10.1111","volume":"33","author":[{"given":"Nobutaka","family":"Nishimura","sequence":"first","affiliation":[{"name":"Department of Urology Nara Medical University  Kashihara Nara 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