To improve the clinical decisionâmaking regarding further treatment management and followâup scheduling for patients with muscleâinvasive bladder cancer (MIBC) after radical cystectomy (RC), a better prediction accuracy of prognosis for these patients is urgently needed. The objective of this study was to evaluate the validity of differentially expressed microRNAs (miRNAs) based on a previous study as prognostic markers for overall survival (OS) after RC in models combined with clinicopathological data. The expression of six miRNAs (miRâ100â5p, miRâ130bâ3p, miRâ141â3p, miRâ199aâ3p, miRâ205â5p, and miRâ214â3p) was measured by RTâqPCR in formalinâfixed, paraffinâembedded tissue samples from 156 MIBC patients who received RC in three urological centers. Samples from 2000 to 2013 were used according to their tissue availability, with followâup until June 2016. The patient cohort was randomly divided into a training (n = 100) and test set (n = 56). Seventyâthree samples from adjacent normal tissue were used as controls. KaplanâMeier, univariate and multivariate Cox regression, and decision curve analyses were carried out to assess the association of clinicopathological variables and miRNAs to OS. Both increased (miRâ130bâ3p and miRâ141â3p) and reduced (miRâ100â5p, miRâ199aâ3p, and miRâ214â3p) miRNA expressions were found in MIBC samples in comparison to nonmalignant tissue samples (P < 0.0001). miRâ199aâ3p and miRâ214â3p were independent markers of OS in Cox regression models with the significant clinicopathological variables age, tumor status, and lymph node status. The prediction model with the clinicopathological variables was improved by these two miRNAs in both sets. The predictive benefit was confirmed by decision curve analysis. In conclusion, the inclusion of both miRNAs into models based on clinical data for the outcome prediction of MIBC patients after RC could be a valuable approach to improve prognostic accuracy.