Urinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking history

Abstract Limited information is currently available on predictors of upper tract urothelial carcinoma (UTUC) recurrence in non-muscle-invasive bladder cancer (NMIBC) patients according to smoking history, although smoking probably contributes to urothelial carcinogenesis. Therefore, the present stud...

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Main Authors: Hiroki Ide, Eiji Kikuchi, Koichiro Ogihara, Naoya Niwa, Keisuke Shigeta, Tsukasa Masuda, Yuto Baba, Ryuichi Mizuno, Mototsugu Oya
Format: Article
Language:English
Published: Nature Portfolio 2021-10-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-00184-y
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author Hiroki Ide
Eiji Kikuchi
Koichiro Ogihara
Naoya Niwa
Keisuke Shigeta
Tsukasa Masuda
Yuto Baba
Ryuichi Mizuno
Mototsugu Oya
author_facet Hiroki Ide
Eiji Kikuchi
Koichiro Ogihara
Naoya Niwa
Keisuke Shigeta
Tsukasa Masuda
Yuto Baba
Ryuichi Mizuno
Mototsugu Oya
author_sort Hiroki Ide
collection DOAJ
description Abstract Limited information is currently available on predictors of upper tract urothelial carcinoma (UTUC) recurrence in non-muscle-invasive bladder cancer (NMIBC) patients according to smoking history, although smoking probably contributes to urothelial carcinogenesis. Therefore, the present study aimed to identify independent predictors of UTUC recurrence in all patients and those with a smoking history. Our study population comprised 1190 NMIBC patients who underwent transurethral resection of bladder tumor. UTUC developed in 43 patients during the follow-up. A history of bacillus Calmette-Guérin (BCG) therapy was independently associated with a lower incidence of UTUC (HR = 0.43; P = 0.011). In a subgroup of NMIBC patients with a smoking history, concomitant carcinoma in situ (CIS) and a lower urinary pH (< 6) were independently associated with a higher incidence of UTUC recurrence (HR = 3.34, P = 0.006 and HR = 3.73, P = 0.008, respectively). Among patients with a longer smoking duration (≥ 20 years) or larger smoking intensity (≥ 20 cigarettes per day), those with lower urinary pH (< 6) had a significantly higher UTUC recurrence rate than their counterparts. These results suggest that BCG instillation may prevent UTUC recurrence in NMIBC patients, while a lower urinary pH and concomitant CIS increase the risk of UTUC recurrence in those with a smoking history.
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spelling doaj.art-7984864f958c4dd8a754a4a8907ca7d82022-12-21T20:37:29ZengNature PortfolioScientific Reports2045-23222021-10-011111910.1038/s41598-021-00184-yUrinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking historyHiroki Ide0Eiji Kikuchi1Koichiro Ogihara2Naoya Niwa3Keisuke Shigeta4Tsukasa Masuda5Yuto Baba6Ryuichi Mizuno7Mototsugu Oya8Department of Urology, Keio University School of MedicineDepartment of Urology, St. Marianna University School of MedicineDepartment of Urology, Keio University School of MedicineDepartment of Urology, Keio University School of MedicineDepartment of Urology, Keio University School of MedicineDepartment of Urology, Keio University School of MedicineDepartment of Urology, Keio University School of MedicineDepartment of Urology, Keio University School of MedicineDepartment of Urology, Keio University School of MedicineAbstract Limited information is currently available on predictors of upper tract urothelial carcinoma (UTUC) recurrence in non-muscle-invasive bladder cancer (NMIBC) patients according to smoking history, although smoking probably contributes to urothelial carcinogenesis. Therefore, the present study aimed to identify independent predictors of UTUC recurrence in all patients and those with a smoking history. Our study population comprised 1190 NMIBC patients who underwent transurethral resection of bladder tumor. UTUC developed in 43 patients during the follow-up. A history of bacillus Calmette-Guérin (BCG) therapy was independently associated with a lower incidence of UTUC (HR = 0.43; P = 0.011). In a subgroup of NMIBC patients with a smoking history, concomitant carcinoma in situ (CIS) and a lower urinary pH (< 6) were independently associated with a higher incidence of UTUC recurrence (HR = 3.34, P = 0.006 and HR = 3.73, P = 0.008, respectively). Among patients with a longer smoking duration (≥ 20 years) or larger smoking intensity (≥ 20 cigarettes per day), those with lower urinary pH (< 6) had a significantly higher UTUC recurrence rate than their counterparts. These results suggest that BCG instillation may prevent UTUC recurrence in NMIBC patients, while a lower urinary pH and concomitant CIS increase the risk of UTUC recurrence in those with a smoking history.https://doi.org/10.1038/s41598-021-00184-y
spellingShingle Hiroki Ide
Eiji Kikuchi
Koichiro Ogihara
Naoya Niwa
Keisuke Shigeta
Tsukasa Masuda
Yuto Baba
Ryuichi Mizuno
Mototsugu Oya
Urinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking history
Scientific Reports
title Urinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking history
title_full Urinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking history
title_fullStr Urinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking history
title_full_unstemmed Urinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking history
title_short Urinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking history
title_sort urinary ph is an independent predictor of upper tract recurrence in non muscle invasive bladder cancer patients with a smoking history
url https://doi.org/10.1038/s41598-021-00184-y
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