Purpose: To explore the feasibility of preoperative fibrinogen / albumin ratio (FAR) as a predictor of the total and elderly patients with urothelial carcinoma after radical cystectomy. Methods: A cohort of 275 patients who underwent radical cystectomy for bladder tumor at Peking University First Hospital from 2012 to 2016 was analyzed retrospectively. The optimal cutoff value of FAR group was determined according to the survival dependent receiver operating characteristic curve (survival-ROC). Kaplan-Meier curve was used to analysis the overall survival (OS), and Cox proportional hazards model was used for univariate and multivariate analysis.
Result: The AUC value of FAR in the survival-ROC curve is higher than other clinical indexes, and the cutoff value of FAR determined by survival-ROC is 0.0707. We found that the median survival time (27.63 months vs 32.11 months, P < 0.01) and 5-year survival rate (77.7% vs 92.7%, P < 0.01) in the high FAR group were significantly lower than those in the low FAR group. In the multivariate survival analysis, the FAR and AJCC stages were independent risk factors for long-term prognosis. In subgroup analysis, the long-term survival of patients in AJCC I+II subgroup, G1 + G2 subgroup, G3 subgroup, lymph nodes negative subgroup and old patient subgroup were all related to FAR, while the 5-years survival of patients in AJCCIII+IV subgroup, lymph nodes positive subgroup and young patient subgroup was not related to FAR.
Conclusion: The value of FAR can be used as an independent risk factor to predict the prognosis of patients with bladder cancer after radical cystectomy, especially for patients with elder age, lymph nodes negative, or AJCC I + II stage.
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