{"id":"https://openalex.org/W7225322820","doi":"https://doi.org/10.21203/rs.3.rs-11180119/v1","title":"Stage and Age Characterize Distinct, Time-Varying Mortality Pathways in Older Adults With Bladder Cancer: A Population-Based Competing-Risk Study","display_name":"Stage and Age Characterize Distinct, Time-Varying Mortality Pathways in Older Adults With Bladder Cancer: A Population-Based Competing-Risk Study","publication_year":2026,"publication_date":"2026-11-05","ids":{"openalex":"https://openalex.org/W7225322820","doi":"https://doi.org/10.21203/rs.3.rs-11180119/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-11180119/v1","doi":"https://doi.org/10.21203/rs.3.rs-11180119/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11180119/v1","pdf_url":"https://www.researchsquare.com/article/rs-11180119/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-11180119/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5127826893","display_name":"Yu Dai","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210124531","display_name":"Lanzhou University Second Hospital","ror":"https://ror.org/02erhaz63","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210124531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yu Dai","raw_affiliation_strings":["Lanzhou University Second Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Lanzhou University Second Hospital","institution_ids":["https://openalex.org/I4210124531"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015562744","display_name":"\u51af\u4e9a\u5f3a","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Yaqiang Feng","raw_affiliation_strings":["Baoji People's Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Baoji People's Hospital","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5137577109","display_name":"Helin Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210124531","display_name":"Lanzhou University Second Hospital","ror":"https://ror.org/02erhaz63","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210124531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Helin Zhang","raw_affiliation_strings":["Lanzhou University Second Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Lanzhou University Second Hospital","institution_ids":["https://openalex.org/I4210124531"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160736178","display_name":"Cheng Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210124531","display_name":"Lanzhou University Second Hospital","ror":"https://ror.org/02erhaz63","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210124531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Cheng Wang","raw_affiliation_strings":["Lanzhou University Second Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Lanzhou University Second Hospital","institution_ids":["https://openalex.org/I4210124531"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5011063775","display_name":"Shuaipeng He","orcid":"https://orcid.org/0000-0002-8374-9070","observed_orcids":["https://orcid.org/0000-0002-8374-9070"]},"institutions":[{"id":"https://openalex.org/I4210124531","display_name":"Lanzhou University Second Hospital","ror":"https://ror.org/02erhaz63","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210124531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Shuaipeng He","raw_affiliation_strings":["Lanzhou University Second Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Lanzhou University Second Hospital","institution_ids":["https://openalex.org/I4210124531"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5102923528","display_name":"Kangjie Wang","orcid":"https://orcid.org/0009-0002-7063-5610","observed_orcids":["https://orcid.org/0009-0002-7063-5610"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Kangjie Wang","raw_affiliation_strings":["Baoji People's Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Baoji People's Hospital","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5136438243","display_name":"Xiaobao Chen","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Xiaobao Chen","raw_affiliation_strings":["Baoji People's Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Baoji People's Hospital","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160629394","display_name":"Qiao Du","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Qiao Du","raw_affiliation_strings":["Baoji People's Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Baoji People's Hospital","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5103102324","display_name":"Panfeng Shang","orcid":"https://orcid.org/0000-0002-9622-9664","observed_orcids":["https://orcid.org/0000-0002-9622-9664","https://orcid.org/0009-0008-2326-9906"]},"institutions":[{"id":"https://openalex.org/I4210124531","display_name":"Lanzhou University Second Hospital","ror":"https://ror.org/02erhaz63","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210124531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Panfeng Shang","raw_affiliation_strings":["Lanzhou University Second Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Lanzhou University Second Hospital","institution_ids":["https://openalex.org/I4210124531"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10458","display_name":"Bladder and Urothelial Cancer Treatments","score":0.9945999979972839,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10458","display_name":"Bladder and Urothelial Cancer Treatments","score":0.9945999979972839,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10556","display_name":"Global Cancer Incidence and Screening","score":0.0010999999940395355,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11011","display_name":"Frailty in Older Adults","score":0.000699999975040555,"subfield":{"id":"https://openalex.org/subfields/2717","display_name":"Geriatrics and Gerontology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/urothelial-bladder-cancer","display_name":"bladder urothelial carcinoma","score":0.9330000281333923},{"id":"https://openalex.org/keywords/older-adults","display_name":"older adults","score":0.949999988079071},{"id":"https://openalex.org/keywords/competing-risks","display_name":"competing risks","score":0.5849999785423279},{"id":"https://openalex.org/keywords/cancer-specific-mortality","display_name":"cancer-specific mortality","score":0.6660000085830688},{"id":"https://openalex.org/keywords/other-cause-mortality","display_name":"other-cause mortality","score":0.902999997138977},{"id":"https://openalex.org/keywords/tumor-stage","display_name":"tumor stage","score":0.9629999995231628},{"id":"https://openalex.org/keywords/age","display_name":"age","score":0.5690000057220459},{"id":"https://openalex.org/keywords/geriatric-assessment","display_name":"geriatric assessment","score":0.9350000023841858},{"id":"https://openalex.org/keywords/cancer-survivorship","display_name":"cancer survivorship","score":0.703000009059906},{"id":"https://openalex.org/keywords/seer-database","display_name":"SEER database","score":0.6629999876022339}],"concepts":[{"id":"https://openalex.org/C207103383","wikidata":"https://www.wikidata.org/wiki/Q3930246","display_name":"Hazard ratio","level":3,"score":0.7896000146865845},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7806000113487244},{"id":"https://openalex.org/C146357865","wikidata":"https://www.wikidata.org/wiki/Q1123245","display_name":"Stage (stratigraphy)","level":2,"score":0.7013000249862671},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.6679999828338623},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.5950000286102295},{"id":"https://openalex.org/C2780352672","wikidata":"https://www.wikidata.org/wiki/Q504775","display_name":"Bladder cancer","level":3,"score":0.4927999973297119},{"id":"https://openalex.org/C172400760","wikidata":"https://www.wikidata.org/wiki/Q332796","display_name":"Survivorship curve","level":3,"score":0.47130000591278076},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.4447999894618988},{"id":"https://openalex.org/C10515644","wikidata":"https://www.wikidata.org/wiki/Q543310","display_name":"Survival analysis","level":2,"score":0.4101000130176544},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.3978999853134155},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.38100001215934753},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3346000015735626},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.3240000009536743},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.3183000087738037},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.31139999628067017},{"id":"https://openalex.org/C29374701","wikidata":"https://www.wikidata.org/wiki/Q1931388","display_name":"Cause of death","level":3,"score":0.26260000467300415},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.2603999972343445},{"id":"https://openalex.org/C49261128","wikidata":"https://www.wikidata.org/wiki/Q1132455","display_name":"Hazard","level":2,"score":0.25699999928474426},{"id":"https://openalex.org/C2994039464","wikidata":"https://www.wikidata.org/wiki/Q217690","display_name":"Cumulative risk","level":2,"score":0.25450000166893005}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-11180119/v1","doi":"https://doi.org/10.21203/rs.3.rs-11180119/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11180119/v1","pdf_url":"https://www.researchsquare.com/article/rs-11180119/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-11180119/v1","doi":"https://doi.org/10.21203/rs.3.rs-11180119/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11180119/v1","pdf_url":"https://www.researchsquare.com/article/rs-11180119/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320337351","display_name":"National Cancer Institute","ror":"https://ror.org/040gcmg81"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225322820.pdf","grobid_xml":"https://content.openalex.org/works/W7225322820.grobid-xml"},"referenced_works_count":27,"referenced_works":["https://openalex.org/W2057847137","https://openalex.org/W2073140442","https://openalex.org/W2078271269","https://openalex.org/W2114586150","https://openalex.org/W2599076725","https://openalex.org/W2805258017","https://openalex.org/W2912017145","https://openalex.org/W2946752399","https://openalex.org/W2959343983","https://openalex.org/W2996480032","https://openalex.org/W3005057004","https://openalex.org/W3014928912","https://openalex.org/W3109225097","https://openalex.org/W3162092977","https://openalex.org/W4214830681","https://openalex.org/W4220818135","https://openalex.org/W4255398094","https://openalex.org/W4384498679","https://openalex.org/W4384663657","https://openalex.org/W4399808968","https://openalex.org/W4401171639","https://openalex.org/W4402965434","https://openalex.org/W4404540529","https://openalex.org/W4405774434","https://openalex.org/W4409989502","https://openalex.org/W4410781855","https://openalex.org/W4417145369"],"related_works":["https://openalex.org/W4317567383","https://openalex.org/W3089262302","https://openalex.org/W2912017145","https://openalex.org/W1428915377","https://openalex.org/W2089075052","https://openalex.org/W2015708189","https://openalex.org/W2095812041","https://openalex.org/W2063922308","https://openalex.org/W4214830681","https://openalex.org/W2085826031"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Older":[2],"adults":[3,38],"with":[4,22,43,87,110],"bladder":[5,44],"cancer":[6],"face":[7],"both":[8],"cancer-related":[9],"and":[10,18,25,54,68,147,159,193,203,209,214,217,247,260],"competing":[11],"mortality.":[12],"We":[13,60],"examined":[14],"how":[15,26],"tumor":[16],"stage":[17,103,106,157,163,171],"age":[19,129,232,261],"were":[20,206],"associated":[21,109],"these":[23],"outcomes":[24],"their":[27],"relative":[28],"hazards":[29],"changed":[30],"during":[31,48],"follow-up.":[32],"Methods":[33],"This":[34],"retrospective":[35],"cohort":[36],"included":[37],"aged":[39],"\u2265":[40,130],"75":[41],"years":[42,134],"urothelial":[45],"carcinoma":[46],"diagnosed":[47],"2010\u20132015":[49],"in":[50,143,156,162,170,190],"the":[51,125,174,182,198,245],"Surveillance,":[52],"Epidemiology,":[53],"End":[55],"Results":[56,99],"17":[57],"Registries":[58],"database.":[59],"used":[61],"Aalen\u2013Johansen":[62],"estimators,":[63],"adjusted":[64],"cause-specific":[65],"Cox":[66],"models":[67,94],"smoothed":[69],"monthly":[70,85],"hazards.":[71],"A":[72],"sustained":[73],"crossover":[74,167],"required":[75],"other-cause":[76,123,220,234],"hazard":[77,81,114,126,139],"to":[78],"exceed":[79],"bladder-cancer":[80,112,212,229],"for":[82,128,211,219,228],"six":[83],"consecutive":[84],"points":[86],"adequate":[88],"numbers":[89],"at":[90,152,187,200],"risk.":[91],"Secondary":[92],"prediction":[93],"underwent":[95],"internal":[96],"temporal":[97],"validation.":[98],"Among":[100],"38,852":[101],"patients,":[102],"IV":[104,172],"versus":[105,132],"0a":[107],"was":[108,135,168],"a":[111,225],"death":[113,179,213],"ratio":[115,127],"of":[116,249],"22.92":[117],"(95%":[118],"confidence":[119],"interval":[120],"21.24\u201324.72).":[121],"For":[122],"death,":[124],"90":[131],"75\u201379":[133],"3.68":[136],"(3.49\u20133.88).":[137],"Other-cause":[138],"predominated":[140],"near":[141],"diagnosis":[142],"stages":[144,191],"0a,":[145],"0is":[146],"I.":[148],"Sustained":[149],"crossovers":[150],"occurred":[151],"approximately":[153],"40.5":[154],"months":[155,161,189,205],"II":[158,192],"56.5":[160],"III;":[164],"no":[165],"stable":[166],"identified":[169],"within":[173],"84-month":[175],"observation":[176],"window.":[177],"Bladder-cancer":[178],"nevertheless":[180],"remained":[181],"more":[183,236],"frequent":[184],"cumulative":[185],"outcome":[186],"84":[188],"III.":[194],"Temporal-validation":[195],"areas":[196],"under":[197],"curve":[199],"12,":[201],"36":[202],"60":[204],"0.855,":[207],"0.822":[208],"0.800":[210],"0.629,":[215],"0.632":[216],"0.644":[218],"death.":[221],"Conclusions":[222],"Stage":[223],"showed":[224],"steeper":[226],"gradient":[227],"mortality,":[230],"whereas":[231],"differentiated":[233],"mortality":[235],"strongly":[237],"than":[238],"stage.":[239],"Their":[240],"changing":[241],"balance":[242],"may":[243],"inform":[244],"timing":[246],"focus":[248],"survivorship":[250],"assessment.":[251,267],"These":[252],"population-level":[253],"patterns":[254],"do":[255],"not":[256],"define":[257],"treatment":[258],"thresholds,":[259],"cannot":[262],"replace":[263],"an":[264],"individual":[265],"geriatric":[266]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-06T00:00:00"}
