Document Type : Original Article


1 Medical Oncology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

2 Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Suez Canal University, Egypt

3 Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt

4 Department of Radiation Therapy Princess Nourah Bint Abdulrhman University, Zagazig, Egypt


Background: Neoadjuvant chemotherapy (NAC) grants a modest survival benefit in localized muscle-invasive bladder cancer (MIBC). We evaluated the pathological response and survival outcome after NAC in stage II and IIIA MIBC and their correlation with body mass index (BMI).
Method: Our retrospective study included stage II (T2 N0) and IIIA (T3 N0, T4 N0, T1-4 N1) MIBC. They received NAC followed by radical cystectomy. The patients were categorized into level I: a BMI of 18.5 – 24.9 kg/m2, level II: a BMI of 25-29.9 kg/m2, and level III: a BMI of ≥ 30 kg/m2.
Results: 103 patients with localized MIBC were included. The median age was 63 years; 35 patients (34.0%) belonged to level I, 40 patients (38.8%) belonged to level II, and 28 patients (27.2%) belonged to level III. Smoking status was more common in level II (51.0%) and level III (36.7%) (P < 0.001). Only 18 patients had ECOG PS 2, all belonging to level III (P < 0.001). After NAC, the pCR was 34.3%, 25%, and 10.7% of level I, level II, and level III (P = 0.03), respectively. Of 19 patients who passed away, 10 patients belonged to level III and 6 patients belonged to level II (P = 0.007). For level I, level II, and level III, the disease-free survival was 23.2 months, 12.7 months, and 10.7 months and the overall survival was 61.9, 52.3, and 28.7 months, respectively.
Conclusion: Obesity and overweight could be predictive and prognostic markers in localized MIBC. These factors are associated with low pCR after NAC, poor disease-free survival, and overall survival.


How to cite this article:

Mohammed A, Elsayed F, Salem R. The impact of body mass index on pathological response and survival outcome after neoadjuvant chemotherapy in localized bladder cancer. Middle East J Cancer. 2023;14(1):136-45. doi: 10. 30476/mejc.2022.90799.1591.

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