Objective To investigate the prognostive value of preoperative fibrinogen (FIB) combined with platelet-lymphocyte ratio (PLR) on the prognosis of patients undergoing radical cystectomy(RC).

Methods We enrolled 141 patients with urothelial carcinoma after radical cystectomy. ROC curve was used to determine the optimal cutoff values of FIB and PLR. The FIB and PLR were divided into the high-level group and the low-level group. If one indicator was high-level or both indicators were high-level, a combination score 1 (S1) was defined. If both indicators were low-level, a combination score 0 (S0) was defined. One-way analysis of variance and non-parametric tests were used to analyze the characteristics of patients, the Kaplan-Meier method was used for univariate survival analysis, the Log rank method was used for testing, and the Cox proportional hazards model was used for multivariate regression analysis.

Results The optimal cutoff values for FIB and PLR were 3.43 and 110.54, respectively. FIB level was closely related to T stage, pathological grade and tumor size (all P < 0.05), and PLR level was closely related to pathological grade and tumor size (P < 0.05). The preoperative combination score was closely related to T stage, N stage, pathological grade and tumor size (all P < 0.05). Combination score, T stage, tumor size, FIB and PLR were important factors affecting the prognosis. Combination score (P=0.019), T stage (P=0.021) and FIB (P=0.010) were independent risk factors for the prognosis.

Conclusion The combination score is an independent risk factor for overall survival of patients undergoing radical cystectomy. It can be used as a new indicator for predicting the tumor progression and prognosis of patients with bladder cancer.