Age and comorbidity impact surgical therapy in older bladder carcinoma patients

Abstract

Body size and food properties account for much of the variation in the hard tissue morphology of the masticatory system whereas their influence on the soft tissue anatomy remains relatively understudied. Data on jaw adductor fiber architecture and experimentally determined ingested food size in a broad sample of 24 species of extant strepsirrhines allows us to evaluate several hypotheses about the influence of body size and diet on the masticatory muscles. Jaw adductor mass scales isometrically with body mass (β = 0.99, r = 0.95), skull size (β = 1.04, r = 0.97), and jaw length cubed (β = 1.02, r = 0.95). Fiber length also scales isometrically with body mass (β = 0.28, r = 0.85), skull size (β = 0.33, r = 0.84), and jaw length cubed (β = 0.29, r = 0.88). Physiological cross‐sectional area (PCSA) scales with isometry or slight positive allometry with body mass (β = 0.76, r = 0.92), skull size (β = 0.78, r = 0.94), and jaw length cubed (β = 0.78, r = 0.91). Whereas PCSA is isometric to body size estimates in frugivores, it is positively allometric in folivores. Independent of body size, fiber length is correlated with maximum ingested food size, suggesting that ingestive gape is related to fiber excursion. Comparisons of temporalis, masseter, and medial pterygoid PCSA in strepsirrhines of different diets suggest that there may be functional partitioning between these muscle groups. Anat Rec, 2011. © 2011 Wiley‐Liss, Inc.

Natural history of pT3-4 or node positive bladder cancer treated with radical cystectomy and no neoadjuvant chemotherapy in a contemporary North-American multi-institutional cohort

“…Prout and colleagues examined the SEER database and found that older patients with more comorbidity were less likely to undergo RC, even in the presence of invasive disease. 14 This tendency to defer definitive therapy may account for the association of higher comorbid disease with more advanced stages of bladder cancer observed in the present cohort.…”

Cutaneous ureterostomy with definitive ureteral stent as urinary diversion option in unfit patients after radical cystectomy

“…bleeding, instead of associated age-related illness 15 . Studies have suggested that co-morbidity and not age is the most important predictor of complications 15,16 . When the decision for a radical cystectomy is made, not the real but much better the ''biological'' age of the patient should be taken into consideration.…”

Comorbidity Relationship to Outcome of Radical Cystectomy in Chinese: a Single Institution Study with the ACE-27 Comorbidity Index

“…The presence of a comorbid condition may not only mask clinical signs of cancer and delay diagnosis, but may also preclude treatment options and even complicate the established cancer and/or effects of treatment (Piccirillo and Feinstein, 1996;Extermann, 2000;Prout et al, 2005;Hall, 2006). Several studies have found that bladder cancer is strongly associated with advanced age and tobacco smoking, each of which is associated with a distinct subset of additional comorbidities (Bjerregaard et al, 2006;Fisher et al, 2009).…”