Preoperative FAN score predicts survival outcomes after radical cystectomy for bladder cancer
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective This study aimed to evaluate whether the preoperative FAN score—composed of the fibrosis‐4 (Fib‐4) index, albumin–bilirubin (ALBI) score and neutrophil–lymphocyte ratio (NLR)—predicts recurrence‐free, cancer‐specific and overall survival after radical cystectomy for bladder cancer. Patients and Methods We retrospectively analysed 1121 patients who underwent radical cystectomy at 13 institutions between April 2010 and March 2024. Associations between the FAN score and recurrence‐free survival (RFS), cancer‐specific survival (CSS) and overall survival (OS) were evaluated. Prognostic performance was assessed in an independent cohort of 296 patients from three institutions. Results FAN score distribution was 0 ( n = 600, 53.5%), 1 ( n = 409, 36.5%) and ≥2 ( n = 112, 10.0%). Patients with a FAN score ≥2 had significantly worse RFS (median: not reached vs 12.3 months; p < 0.0001), CSS (not reached vs 22.8 months; p < 0.0001) and OS (112.5 vs 16.1 months; p < 0.0001) than those with a FAN score ≤1. On multivariable analysis, a FAN score ≥2 was an independent predictor of poorer RFS (HR 2.12, 95% CI 1.55–2.91; p < 0.0001), CSS (HR 2.80, 95% CI 2.00–3.92; p < 0.0001) and OS (HR 2.70, 95% CI 2.03–3.59; p < 0.0001). These associations were consistently observed in an independent cohort of 296 patients. Conclusions The FAN score is an independent prognostic marker of adverse outcomes after radical cystectomy for bladder cancer and may help stratify patients for perioperative management and follow‐up.
Source: BJUI Compass
DOI: 10.1002/bco2.70221
Authors: Yu Ishizuya, Atsunari Kawashima, Shimpei Yamashita, Takeshi Ujike, Tetsuya Takao, Osamu Miyake, Hiroki Osaki, Hiromu Horitani, Toshichika Iwanishi, Tsuyoshi Takada, Yuta Oki, Takahiro Yoshida, Makoto Matsushita, Ken‐Ichi Kakimoto, Akira Nagahara, Takuji Hayashi, Yoshiyuki Yamamoto, Taigo Kato, Koji Hatano, Yasuo Kohjimoto, Isao Hara, Norio Nonomura
Institutions: The University of Osaka, Wakayama Medical University, Wakayama University, Osaka Rosai Hospital, Osaka Prefectural Medical Center, Toyonaka Municipal Hospital, Osaka Police Hospital, Sakai Municipal Hospital, Minoh City Hospital, Osaka National Hospital, Hyogo Prefectural Nishinomiya Hospital, Ikeda Municipal Hospital, Nippon Life Hospital, Osaka International Cancer Institute
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,770
OpenAlex ID: W7159926166