Summary of the best evidence for whole-course nutritional management of bladder cancer

Abstract

Objectives To synthesize the best evidence for whole-course nutritional management of bladder cancer (BC) and to obtain a structured summary of evidence for clinical guidance. Methods A full search was conducted in multiple websites and databases (11 electronic databases, 10 guideline websites, and 14 major professional society websites) for expert consensus, expert recommendations, guidelines, evidence summaries, randomized controlled trials, and systematic reviews related to BC nutrition until December 2025, with a supplementary search in January 2026. The included studies underwent quality assessment, extraction and summary of evidence, and two-round Delphi expert consultation. A total of 17 experts were invited to participate in the first round, and 15 experts were invited in the second round. Results Sixteen studies were included: one expert recommendation, one clinical decision, three expert consensus articles, four evidence summaries, and seven guidelines. We summarized 91 evidence statements across seven dimensions: nutrition team formation and management processes, three-tier nutritional diagnosis, principles of nutrition support therapy, content of nutritional interventions, nutritional surveillance, health education, and nutritional follow-up. The expert authority coefficient (Cr) was 0.88 for both rounds of consultation, and Kendall’s coefficients of concordance were 0.250 and 0.313, respectively, indicating acceptable expert authority. Conclusion This study summarized the best evidence for whole-course nutritional management of BC across treatment methods and nutritional statuses. The findings lay an evidence-based basis for clinical practice, especially for patients with nutritional risk undergoing radical cystectomy. Systematic review registration https://nursing.fudan.edu.cn/38724/list.htm, identifier ES20258783.