Association between the red cell distribution width-to-albumin ratio and recurrence-free survival and overall survival in patients with non-muscle-invasive bladder cancer: a retrospective cohort study

作者：Feifan Song, Shiqiang Su, X. Zhang, Yunpeng Cao, Xiongjie Cui, L. Zhang, Chao Li, Shen Li · 发表于：Frontiers in Oncology · 年份：2026 · DOI：10.3389/fonc.2025.1710047 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Bladder and Urothelial Cancer Treatments、MRI in cancer diagnosis

Background: The prognostic utility of the red cell distribution width-to-albumin ratio (RAR) in non-muscle-invasive bladder cancer (NMIBC) has not been established. This study aimed to evaluate the associations between preoperative RAR and both recurrence-free survival (RFS) and overall survival (OS) in patients with NMIBC. Methods: A retrospective review was performed for 240 individuals with NMIBC having undergone transurethral resection of bladder tumor (TURBT) at Shijiazhuang People's Hospital from November 2013 to January 2024. Demographic characteristics, hematological parameters, pathological data, and information on instillation therapy were collected. The optimal RAR cutoff was identified by applying receiver operating characteristic (ROC) analysis. Survival curves were generated via the Kaplan-Meier method. The relationships of RAR with both RFS and OS were examined using univariate and multivariate Cox proportional hazards regression models. A nomogram was created using the identified independent prognostic factors from multivariate analysis to predict RFS. The discriminative ability and clinical usefulness of the nomogram were assessed by the concordance index (C-index), the calibration plots, time-dependent ROC analysis, and decision curve analysis (DCA). Results: Patients with higher preoperative RAR showed significantly poorer RFS and OS. Multivariate analysis identified high RAR as an independent prognostic factor for both RFS (HR: 1.731, 95% CI: 1.012 - 2.959...