Acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomy
PurposeTo assess the prognostic value of acidic urine (low urine pH) in patients with bladder cancer undergoing radical cystectomy.Materials and methodsWe reviewed patients enrolled in the Seoul National University Prospectively Enrolled Registry for Urothelial Cancer-Cystectomy (SUPER-UC-Cx) who un...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.964571/full |
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| author | Jang Hee Han Seung-hwan Jeong Hyeong Dong Yuk Hyeong Dong Yuk Chang Wook Jeong Chang Wook Jeong Cheol Kwak Cheol Kwak Ja Hyeon Ku Ja Hyeon Ku |
| author_facet | Jang Hee Han Seung-hwan Jeong Hyeong Dong Yuk Hyeong Dong Yuk Chang Wook Jeong Chang Wook Jeong Cheol Kwak Cheol Kwak Ja Hyeon Ku Ja Hyeon Ku |
| author_sort | Jang Hee Han |
| collection | DOAJ |
| description | PurposeTo assess the prognostic value of acidic urine (low urine pH) in patients with bladder cancer undergoing radical cystectomy.Materials and methodsWe reviewed patients enrolled in the Seoul National University Prospectively Enrolled Registry for Urothelial Cancer-Cystectomy (SUPER-UC-Cx) who underwent radical cystectomy for bladder cancer between March 2016 and December 2020 at the Seoul National University Hospital. During this period, 368 patients were registered in our database. To eliminate confounding factors, we excluded patients diagnosed with non-urothelial cancer and end-stage renal disease.ResultsA total of 351 patients with a mean age of 69.8 ± 10.5 years and median follow-up of 16.0 months were eligible for the analysis. The mean preoperative urine pH was 6.0. The patients were divided into low (pH ≤ 5.5) and high (pH≥6.0) urine pH groups for comparison. All clinicopathological features, including the tumor size, grade, and stage were comparable between the low and high urine pH groups. A Cox regression analysis was performed to assess the independent effect of acidic urine on patient survival. A multivariate analysis showed that high T stage (T3-4) (hazard ratio (HR) 5.18, P<0.001), decreased renal function (estimated glomerular filtration rate <60 mL/min/1.73 m2) (HR 2.29, P=0.003), and low urine pH (≤5.5) (HR 1.69, P=0.05) were associated with shortened recurrence-free survival (RFS). Regarding the overall survival (OS), high T stage (T3-4) (HR 7.15, P<0.001) and low urine pH (≤5.5) (HR 2.66, P=0.029) were significantly associated with shortened survival. A Kaplan–Meier analysis demonstrated that the acidic urine group showed shorter RFS (P=0.04) and OS (P=0.028) than the other groups.ConclusionsAcidic urine was independently associated with reduced RFS and OS in patients with bladder cancer undergoing radical cystectomy. Acidic urine contributing to an acidic tumor environment may promote aggressive behavior in bladder cancer. |
| first_indexed | 2024-04-14T03:16:14Z |
| format | Article |
| id | doaj.art-bcab0c971cdc41ca8d165679e9f9b0a8 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-14T03:16:14Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-bcab0c971cdc41ca8d165679e9f9b0a82022-12-22T02:15:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-08-011210.3389/fonc.2022.964571964571Acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomyJang Hee Han0Seung-hwan Jeong1Hyeong Dong Yuk2Hyeong Dong Yuk3Chang Wook Jeong4Chang Wook Jeong5Cheol Kwak6Cheol Kwak7Ja Hyeon Ku8Ja Hyeon Ku9Department of Urology, Seoul National University Hospital, Seoul, South KoreaDepartment of Urology, Seoul National University Hospital, Seoul, South KoreaDepartment of Urology, Seoul National University Hospital, Seoul, South KoreaDepartment of Urology, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Urology, Seoul National University Hospital, Seoul, South KoreaDepartment of Urology, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Urology, Seoul National University Hospital, Seoul, South KoreaDepartment of Urology, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Urology, Seoul National University Hospital, Seoul, South KoreaDepartment of Urology, Seoul National University College of Medicine, Seoul, South KoreaPurposeTo assess the prognostic value of acidic urine (low urine pH) in patients with bladder cancer undergoing radical cystectomy.Materials and methodsWe reviewed patients enrolled in the Seoul National University Prospectively Enrolled Registry for Urothelial Cancer-Cystectomy (SUPER-UC-Cx) who underwent radical cystectomy for bladder cancer between March 2016 and December 2020 at the Seoul National University Hospital. During this period, 368 patients were registered in our database. To eliminate confounding factors, we excluded patients diagnosed with non-urothelial cancer and end-stage renal disease.ResultsA total of 351 patients with a mean age of 69.8 ± 10.5 years and median follow-up of 16.0 months were eligible for the analysis. The mean preoperative urine pH was 6.0. The patients were divided into low (pH ≤ 5.5) and high (pH≥6.0) urine pH groups for comparison. All clinicopathological features, including the tumor size, grade, and stage were comparable between the low and high urine pH groups. A Cox regression analysis was performed to assess the independent effect of acidic urine on patient survival. A multivariate analysis showed that high T stage (T3-4) (hazard ratio (HR) 5.18, P<0.001), decreased renal function (estimated glomerular filtration rate <60 mL/min/1.73 m2) (HR 2.29, P=0.003), and low urine pH (≤5.5) (HR 1.69, P=0.05) were associated with shortened recurrence-free survival (RFS). Regarding the overall survival (OS), high T stage (T3-4) (HR 7.15, P<0.001) and low urine pH (≤5.5) (HR 2.66, P=0.029) were significantly associated with shortened survival. A Kaplan–Meier analysis demonstrated that the acidic urine group showed shorter RFS (P=0.04) and OS (P=0.028) than the other groups.ConclusionsAcidic urine was independently associated with reduced RFS and OS in patients with bladder cancer undergoing radical cystectomy. Acidic urine contributing to an acidic tumor environment may promote aggressive behavior in bladder cancer.https://www.frontiersin.org/articles/10.3389/fonc.2022.964571/fullurine pHacidicbladder cancerrecurrencesurvival |
| spellingShingle | Jang Hee Han Seung-hwan Jeong Hyeong Dong Yuk Hyeong Dong Yuk Chang Wook Jeong Chang Wook Jeong Cheol Kwak Cheol Kwak Ja Hyeon Ku Ja Hyeon Ku Acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomy Frontiers in Oncology urine pH acidic bladder cancer recurrence survival |
| title | Acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomy |
| title_full | Acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomy |
| title_fullStr | Acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomy |
| title_full_unstemmed | Acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomy |
| title_short | Acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomy |
| title_sort | acidic urine is associated with poor prognosis in patients with bladder cancer undergoing radical cystectomy |
| topic | urine pH acidic bladder cancer recurrence survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.964571/full |
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