This study aimed to develop a cost-effective molecular subtyping strategy using immunohistochemistry (IHC) as surrogate markers and to construct a novel risk stratification model integrating driver genes (<i>TP53/FGFR3</i>) for predicting postoperative recurrence-free survival (RFS).<h4>Methods</h4>We retrospectively analyzed 215 patients with UTUC who underwent radical nephroureterectomy between 2021 and 2024. The gene discussed is FGFR3; the disease is renal pelvis/ureter urothelial carcinoma.