Effects of Neoadjuvant Chemotherapy Treatment on Perioperative Outcomes Following Radical Cystectomy

Objective: This study aimed to assess the impact of neoadjuvant chemotherapy (NAC) on perioperative outcomes in patients undergoing radical cystectomy (RC) for urothelial carcinoma. Materials and Methods: We retrospectively analyzed the clinical records of 317 patients who underwent RC and ileal loop diversion between February 2019 and May 2025. Patients were categorized into NAC+RC and RC-only groups. Demographic, preoperative, intraoperative, and postoperative variables were evaluated. Propensity score matching (PSM) was conducted to match the groups in a 1:1 ratio using the nearest-neighbor matching algorithm in terms of age, body mass index (BMI), previous surgery history, American Society of Anesthesiologists (ASA) score, preoperative T stage, hemoglobin, white blood cell (WBC), incision length and urinary diversion technique. Results: Among the 317 patients, 60 (18.9%) received NAC+RC and 257 (81.1%) underwent RC alone. Preoperative T2 stage was more prevalent in the NAC group compared with the RConly group (85% vs. 68.5%, p=0.024). Preoperative hemoglobin (12.6 vs. 11.9 g/dL, p=0.006) and white blood cell levels (8886.9 vs. 7416.8/μL, p