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Patients With Bladder Cancer and a Smoking History: Can Urinary pH Predict Recurrence?

By: Cordi Craig, MS
Posted: Thursday, November 18, 2021

Although it is likely that smoking contributes to urinary carcinoma, data remain limited on the predictors of recurrence of upper tract urothelial carcinoma among patients with non–muscle-invasive bladder cancer and a history of smoking. According to a study published in Scientific Reports, bacillus Calmette-Guérin (BCG) therapy may help prevent the recurrence of upper tract urothelial carcinoma among patients with non–muscle-invasive bladder cancer. Mototsugu Oya, MD, PhD, of Keio University, Tokyo, and colleagues also suggested that a lower urinary pH and concomitant carcinoma in situ may be independent predictors of disease recurrence among patients with a history of smoking.

The researchers sought to identify independent predictors of upper tract urothelial carcinoma among 1,190 patients with non–muscle-invasive bladder cancer who underwent transurethral resection of the tumor. Patients were evaluated based on smoking history. During follow-up, upper tract urothelial carcinoma was reported in 43 patients.

Patients with a history of BCG therapy appeared to have a lower incidence of upper tract urothelial carcinoma recurrence (P = .011). Concomitant carcinoma in situ and acidic urine (pH < 6) were significantly associated with a higher incidence of upper tract recurrence among patients with a history of smoking (P = .006 and P = .008, respectively). Among patients with a long history of smoking (at least 20 years) or who smoked heavily (at least 20 cigarettes per day), those with a low urinary pH were also significantly more likely to develop upper tract urinary carcinoma recurrence (P = .01 and P = .02).

“Monitoring urine pH and modifications to pH for urine alkalization may benefit patients [with non–muscle invasive bladder cancer and] a positive smoking history,” the study team concluded.

Disclosure: The study authors reported no conflicts of interest.



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