{
  "abstract": "Background\n\nSurgical trauma is associated with perioperative immune perturbation in muscle-invasive bladder cancer (MIBC). Enhanced Recovery After Surgery (ERAS) combines multidisciplinary perioperative management with structured nursing care, but its immunogenomic associations remain incompletely characterized.Methods\n\nThis retrospective historical-control cohort included 126 MIBC patients undergoing radical cystectomy with Bricker ileal conduit (ERAS-based care, n = 63; conventional care, n = 63). Serial peripheral immune profiling was performed at T0 (preoperative), T1 (24 h postoperative), and T2 (POD7/discharge). Tumor analyses included multiplex immunofluorescence, tumor mutational burden (TMB), and NanoString immune-gene profiling; spatial transcriptomics was performed in 24 specimens (12/group). Clinical outcomes included 30-day infectious complications and survival, while biomarker and immunogenomic analyses were considered exploratory.Results\n\nERAS-based care was associated with a less pronounced postoperative CD8⁺ T-cell decline (22.8% vs. 41.6%, P < 0.001) and lower T1 serum IL-6 (43.2 vs. 87.4 pg/mL, P < 0.001). An exploratory four-marker T1 immune index (CD8⁺ count, IL-6, sPD-L1, and NK activity) showed predictive performance for 30-day infectious complications (AUC = 0.84, 95% CI 0.76-0.92). In resection specimens, the ERAS cohort had a higher proportion of the immune-inflamed tumor immune microenvironment (TIME) phenotype (52.4% vs. 28.6%, P = 0.012). Exploratory survival analyses also identified associations with an eight-gene immune signature and TMB status; these findings require validation.Conclusion\n\nIn this retrospective cohort, ERAS-based perioperative nursing and multidisciplinary care were associated with differences in systemic immune recovery, postoperative outcomes, and cross-sectional tumor immune features. The proposed immune-marker and gene-signature findings are exploratory and require independent validation before clinical implementation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Urology / Nursing Department, Cangzhou Central Hospital of Hebei Province, Cangzhou, Hebei, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lu-Lu Xin"
    },
    {
      "affs": [
        0
      ],
      "name": "Jin-Jin Guo"
    },
    {
      "affs": [
        0
      ],
      "name": "Xin-Ying Zheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhao-Yang Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/37wqfpg1j45fn.bib",
  "cited_by": 0,
  "doi": "10.3389/fgene.2026.1967034",
  "fulltext_url": "https://europepmc.org/articles/PMC13713013",
  "id": "37wqfpg1j45fn",
  "issns": [
    "1664-8021"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948804",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2746|Enhanced Recovery After Surgery"
    ]
  ],
  "openalex": "W7221619887",
  "pdf_url": "https://europepmc.org/articles/PMC13713013?pdf=render",
  "pmcid": "PMC13713013",
  "pmid": "42948804",
  "published": "2026-10-14",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/37wqfpg1j45fn.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:34Z",
      "native_id": "MED:42948804",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948804"
    },
    {
      "first_seen": "2026-10-31T12:23:29Z",
      "native_id": "PMC13713013",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fgene.2026.1967034"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Enhanced Recovery After Surgery",
      "subfield": "surgery"
    }
  ],
  "title": "Perioperative immunogenomics and clinical outcomes under ERAS-based nursing care in muscle-invasive bladder cancer.",
  "title_text": "Perioperative immunogenomics and clinical outcomes under ERAS-based nursing care in muscle-invasive bladder cancer.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:23:29Z",
  "url": "https://research.draconitic.com/paper/37wqfpg1j45fn",
  "venue": "Frontiers in genetics",
  "versions": []
}