Postoperative Neutrophil-to-Albumin Ratio as a Prognostic Marker for Patients with Bladder Cancer Undergoing Radical Cystectomy: A Retrospective Observational Cohort Study

Wei Li,1,* Chenhui Xiang,1,* Guoping Xie,1 Yuanyuan Zhang2 1Department of Urology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China; 2Department of Clinical Laboratory Medicine, Xindu District People’s Hospital of Chengdu, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuanyuan Zhang, Department of Clinical Laboratory Medicine, Xindu District People’s Hospital of Chengdu, No. 199, the South Section of Yuying Road, Xindu District, Chengdu, Sichuan, 610500, People’s Republic of China, Email [email protected] Guoping Xie, Department of Urology, The First Affiliated Hospital of Chengdu Medical College, No. 278, the Middle Section of Baoguang Avenue, Xindu District, Chengdu, Sichuan, 610500, People’s Republic of China, Email [email protected]: This study aimed to investigate the prognostic value of the postoperative neutrophil-to-albumin ratio (NAR) in patients with bladder cancer undergoing radical cystectomy.Patients and Methods: A total of 368 patients with histologically confirmed bladder cancer who underwent radical cystectomy between January 2018 and December 2021 were retrospectively analyzed. Postoperative NAR was calculated using neutrophil count (%) and serum albumin concentration (g/L) measured approximately three months after surgery. Receiver operating characteristic analysis identified the optimal NAR cutoff value for predicting 5-year overall survival. Kaplan–Meier and Cox regression models were used to assess associations between NAR and overall survival or recurrence-free survival.Results: The optimal NAR cutoff value was 2.6 with an AUC value of 0.76. Elevated NAR was significantly correlated with bladder cancer of invasive pathological types (p = 0.005), advanced tumor stage (p