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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-Gu\u00e9rin (BCG) therapy was independently associated with a lower incidence of UTUC (HR\u2009=\u20090.43; <jats:italic>P<\/jats:italic>\u2009=\u20090.011). In a subgroup of NMIBC patients with a smoking history, concomitant carcinoma in situ (CIS) and a lower urinary pH (&lt;\u20096) were independently associated with a higher incidence of UTUC recurrence (HR\u2009=\u20093.34, <jats:italic>P<\/jats:italic>\u2009=\u20090.006 and HR\u2009=\u20093.73, <jats:italic>P<\/jats:italic>\u2009=\u20090.008, respectively). Among patients with a longer smoking duration (\u2265\u200920\u00a0years) or larger smoking intensity (\u2265\u200920 cigarettes per day), those with lower urinary pH (&lt;\u20096) 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.<\/jats:p>","DOI":"10.1038\/s41598-021-00184-y","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T10:04:50Z","timestamp":1634637890000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Urinary pH is an independent predictor of upper tract recurrence in non-muscle-invasive bladder cancer patients with a smoking history"],"prefix":"10.1038","volume":"11","author":[{"given":"Hiroki","family":"Ide","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Kikuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Ogihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Niwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Shigeta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsukasa","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuto","family":"Baba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuichi","family":"Mizuno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mototsugu","family":"Oya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"184_CR1","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1016\/S0022-5347(05)67137-6","volume":"164","author":"F Millan-Rodriguez","year":"2000","unstructured":"Millan-Rodriguez, F., Chechile-Toniolo, G., Salvador-Bayarri, J., Huguet-Perez, J. & Vicente-Rodriguez, J. 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