Objective  To investigate the prognostic value of circulating tumor cells (CTCs) and circulating tumor-derived endothelial cells (CTECs) in preoperative peripheral blood of patients with urothelial carcinoma (UC).

  Methods  Clinicopathological data of 161 patients treated at Affiliated Hospital of Chengde Medical College from May 2018 to January 2020 were collected; 100 patients with UC were included in the test group, and 46 patients with benign diseases of the urothelium and 15 healthy patients were included in the control group. The CTCs and CTECs were enriched and stained using subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH).The receiver operating characteristic (ROC) curve analysis was used to determine cut-off values for diagnosing CTCs and CTECs, which were used to classify positive and negative groups, and analyze their relationship with clinical characteristics of patients with UC. The Kaplan–Meier method and a Cox proportional risk regression model for multivariate analysis were used for survival analysis.

  Results  The cut-off value for both CTCs and CTECs was 0.5 according to the ROC curve analysis. The median follow-up durations were 12.0 and 12.5 months for the positive CTC and CTEC groups, respectively, and 20.0 and 16.5 months for the negative CTC and CTEC groups, respectively. The multivariate analysis using the Cox proportional risk regression model showed that CTEC positivity was an independent prognostic factor for patients with UC.

  Conclusions  Preoperative CTCs and CTECs in the peripheral circulating blood of patients could predict the prognosis of patients with UC, and CTECs were independent factors affecting prognosis.