 This study found that a cancer-associated fibroblast, CaF, associated signature could accurately predict the prognosis and response to immunotherapy in patients with bladder urophilial cosonoma, BLCA. This signature consists of 27 genes, which were identified by weighted gene co-expression network analysis, WGCNA. Patients with high CaF scores had significantly poorer outcomes compared to those with low CaF scores, and CaF scores were also found to be independent risk factors. Additionally, patients with high CaF scores did not respond to immunotherapy, while those with lower CaF scores showed positive responses to immunotherapy. These findings suggest that the CaF-associated signature may be useful for guiding personalized treatment plans in patients with BLCA. This article was authored by IWAGU, Anhuishwa.