Preoperative C-reactive protein-to-albumin ratio as a prognostic marker of histopathological characteristics and survival outcomes following radical cystectomy.

INTRODUCTION: Bladder cancer represents the second most common urological malignancy in Europe, and radical cystectomy is the cornerstone of treatment for muscle-invasive bladder cancer. Current research highlights the prognostic significance of markers reflecting inflammatory and nutritional status in oncology. As such, the aim of our study was to investigate the prognostic value of the C-reactive protein-to-albumin ratio (CAR) for histopathological characteristics and survival in bladder cancer patients who underwent radical cystectomy. METHODS: A retrospective cohort study was conducted comprising 491 patients treated with radical cystectomy between 2017 and 2021, with postoperative survival follow up in June 2022. RESULTS: Our results demonstrate that CAR is statistically significantly higher in patients with non-urothelial carcinoma compared to patients with urothelial carcinoma in the presence of lymphovascular invasion and cases of positive lymph nodes. CAR directly correlates with the pathological tumor stage. Multivariate analysis revealed that alongside histopathological tumor characteristics, CAR and age are independent predictors of patient survival following radical cystectomy. DISCUSSION: Our study demonstrated a multifaceted association between CAR and the histopathological characteristics of bladder cancer following radical cystectomy. Furthermore, it was shown that CAR is an independent predictor of survival in these patients.