Biomarkers for Recurrence and Prognosis in Metastatic Urothelial Cancer: Emerging Clinical Applications

Urothelial cancer (UC) remains a highly recurrent and heterogeneous malignancy in which reliable biomarkers for recurrence and prognosis are needed, particularly in the metastatic setting. In recent years, the identification and validation of biomarkers have become an essential pillar for improving the diagnosis, monitoring, and prognosis of this disease. This review summarizes and analyzes recent advances in the study of serological, urinary, histological, genetic, and microRNA biomarkers, as well as emerging tools such as circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA). Together, these non-invasive markers show significant potential to complement conventional diagnostic techniques, optimize risk stratification, and support a more personalized therapeutic approach. Furthermore, the integration of new sequencing technologies and liquid biopsy methods is opening new perspectives for the early detection of recurrence and the dynamic assessment of treatment response. However, the routine clinical implementation of these biomarkers still requires validation through standardized prospective studies.