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001). EN support was identified as the only independent factor adversely associated with severe SMI reduction (p0.001). Patients with low SMI after neoadjuvant chemotherapy were more susceptible to postoperative complications than patients with moderate SMI (47.6% vs 16.7%, p=0.007), especially pulmonary complications (31.8% vs 10.8%, p=0.003). Patients with low SMI after neoadjuvant chemotherapy tended to show worse prognosis than patients with moderate SMI (5-year overall survival rate 43.8% vs 62.1%, p=0.194). Compared with PN s