{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:59:49Z","timestamp":1787029189254,"version":"build-2736575974"},"reference-count":28,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Radical cystectomy (RC) is the standard treatment for muscle invasive bladder cancer (MIBC). Neoadjuvant chemotherapy (NAC) is associated with improved patient survival. The impact of NAC on nutritional status is understudied, while the association between malnutrition and poor surgical outcomes is well known. This study aims to examine the association between NAC, nutritional status impairment, and post-operative morbidity. Materials and Methods: We included MIBC patients who underwent RC and received NAC from multiple academic centers in Israel. Cross-sectional imaging was used to measure the psoas muscle area and normalized it by height (smooth muscle index, SMI). Pre- and post-NAC SMI difference was calculated (represents nutritional status change). The primary outcomes were post-RC ileus, infection, and a composite outcome of any complication. Logistic regression models were fit to identify independent predictors of the outcomes. Results: Ninety-one patients were included in the study. The median SMI change was \u22120.71 (\u22121.58, \u22120.06) cm2\/m2. SMI decline was significantly higher in patients with post-RC complications (\u221218 vs. \u2212203, p &lt; 0.001). SMI change was an independent predictor of all complications, ileus, infection, and other complications. The accuracy of SMI change for predicting all complications, ileus, infection, and other complications was 0.85, 0.87, 0.75, and 0.86, respectively. Conclusions: NAC-related nutritional deterioration is associated with increased risk of complications after RC. Our results hint towards the need for nutritional intervention during NAC prior to RC.<\/jats:p>","DOI":"10.3390\/nu13124471","type":"journal-article","created":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T22:06:10Z","timestamp":1639519570000},"page":"4471","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Nutritional Status Impairment Due to Neoadjuvant Chemotherapy Predicts Post-Radical Cystectomy Complications"],"prefix":"10.3390","volume":"13","author":[{"given":"Sharon","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Urology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Gal","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Urology, Shamir Medical Center, Tzrifin 7073001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuval","family":"Freifeld","sequence":"additional","affiliation":[{"name":"Department of Urology, Carmel Medical Center, Haifa 3436212, Israel"},{"name":"Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3109601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sobhi","family":"Khoury","sequence":"additional","affiliation":[{"name":"Department of Urology, Carmel Medical Center, Haifa 3436212, Israel"},{"name":"Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3109601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoram","family":"Dekel","sequence":"additional","affiliation":[{"name":"Department of Urology, Carmel Medical Center, Haifa 3436212, Israel"},{"name":"Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3109601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azik","family":"Hofman","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3109601, Israel"},{"name":"Department of Urology, Rambam Medical Center, Haifa 3109601, Israel"},{"name":"Israel Urologic Oncology Collaboration, Petah-Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Malshi","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3109601, Israel"},{"name":"Department of Urology, Rambam Medical Center, Haifa 3109601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilad","family":"Amiel","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3109601, Israel"},{"name":"Department of Urology, Rambam Medical Center, Haifa 3109601, Israel"},{"name":"Israel Urologic Oncology Collaboration, Petah-Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itay","family":"Sagi","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Israel Urologic Oncology Collaboration, Petah-Tikva 4941492, Israel"},{"name":"Department of Urology, Meir Medical Center, Kfar Sab 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Leibovici","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Urology, Meir Medical Center, Kfar Sab 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Golan","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Israel Urologic Oncology Collaboration, Petah-Tikva 4941492, Israel"},{"name":"Department of Urology, Rabin Medical Center, Petah-Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Baniel","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Urology, Rabin Medical Center, Petah-Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barak","family":"Rozenzweig","sequence":"additional","affiliation":[{"name":"Department of Urology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Israel Urologic Oncology Collaboration, Petah-Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohar","family":"Dotan","sequence":"additional","affiliation":[{"name":"Department of Urology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3092-4170","authenticated-orcid":false,"given":"Miki","family":"Haifler","sequence":"additional","affiliation":[{"name":"Department of Urology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Israel Urologic Oncology Collaboration, Petah-Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21654","article-title":"Cancer Statistics, 2021","volume":"71","author":"Siegel","year":"2021","journal-title":"CA Cancer J. 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