Preoperative FAN score predicts survival outcomes after radical cystectomy for bladder cancer

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: < 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.