To explore the value of preoperative fibrinogen to albumin ratio (FAR) in predicting postoperative recurrence in NMIBC patients after transurethral resection of bladder tumor (TURBT), and to construct a nomogram model for predicting postoperative recurrence in NMIBC patients based on FAR.

Clinical data from 162 NMIBC patients treated at Zhongshan City People's Hospital Affiliated to Guangdong Medical University from September 2016 to December 2021 was retrospectively analyzed. Cox regression model was used to screen for independent risk factors for postoperative recurrence in NMIBC patients and a nomogram model was constructed.

The no recurrence survival rate of patients in the preoperative low FAR group was better than that in the preoperative high FAR group (P<0.05), and there was a statistically significant difference in tumor number and pathological grading between the two groups (P<0.05). Preoperative high FAR, number of tumors ≥8, clinical T₁ stage, and high pathological grade are independent risk factors for recurrence in patients (P<0.05). The nomogram model constructed from the above four factors predicts the ROC area under the curve for 1 year, 3 year, and 5 year recurrence free survival in NMIBC patients after TURBT, with ROC values of 0.87 (95%CI:0.81-0.94), 0.80 (95%CI:0.70-0.89), and 0.73 (95%CI:0.56-0.89), respectively. At 1 year, 3 years, and 5 years after surgery, the overall clinical benefits of the nomogram model (clinical T stage+pathological grade+number of tumors+FAR) were higher than those of the non FAR factor model (clinical T stage+pathological grade+number of tumors).

Preoperative high FAR is an independent risk factor for postoperative recurrence in NMIBC patients undergoing TURBT. The nomogram model constructed based on FAR can provide theoretical basis for the subsequent treatment of NMIBC patients undergoing TURBT and the formulation of personalized follow-up plans, guiding clinical practice to a certain extent.