Update Series (2023) Lesson 12: Adjuvant and Early Salvage Therapy Recommendations Following Radical Surgery in Urologic Cancers

ERRATUM NOTICE

An erratum has been issued for Update Series (2023) Lesson 12: Adjuvant and Early Salvage Therapy Recommendations Following Radical Surgery in Urologic Cancers. Question 3 is as follows. The online and PDF versions have been updated to reflect this change.

3. You are having a discussion with a multidisciplinary colleague about a mutual patient. The patient is a 67-year-old man with muscle-invasive bladder cancer, clinically localized. Your colleague argues the patient should proceed directly to radical cystectomy because the absolute benefit of neoadjuvant chemotherapy is small and adjuvant chemotherapy trials have proven to have good oncologic efficacy. Your response, based on the AUA Guidelines, should be to

a. Agree, citing randomized trial data demonstrating a definite overall survival benefit to adjuvant chemotherapy
b. Agree, citing the results of 2 meta-analyses demonstrating an overall survival benefit of 50% with adjuvant chemotherapy
c. Disagree, citing randomized trial data demonstrating no overall survival benefit to neoadjuvant chemotherapy
d. Disagree, citing 2 meta-analyses composed of underpowered trial data insufficient for demonstrating a definite benefit to adjuvant chemotherapy

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Target Audience

  • Urologist
  • Resident

Learning Objectives

At the conclusion of this continuing medical education activity, the participant will be able to identify risk factors in patients with localized urological cancer who are candidates for adjuvant or salvage therapy, engage with colleagues in multidisciplinary discussions regarding the evidence supporting medical decision-making and treatment in adjuvant or salvage therapy situations, describe the evidence supporting medical decision-making and treatment in adjuvant or early salvage therapy with respect to high-risk prostate cancer following surgery, and identify and engage in multidisciplinary discussions regarding the evidence supporting adjuvant therapy for patients with renal cell and urothelial carcinoma.

Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Non-Physician Participation
Course opens: 
04/01/2023
Course expires: 
04/30/2026
Rating: 
0

EDUCATION COUNCIL DISCLOSURES

PDF icon Education Council Disclosures.pdf

COI REVIEW WORK GROUP DISCLOSURES

PDF icon COI Review Work Group Disclosures.pdf

UPDATE SERIES EDITORIAL COMMITTEE DISCLOSURES

PDF icon Update Series Editorial Committee.pdf

AUA Office of Education Staff has nothing to disclose.

All relevant financial relationships have been mitigated.

Author(s)

Michael Cookson, MD,MHA

has a financial relationship (Consultant or Advisor (Oncology)) with TesoRx Pharma LLC;.
has a financial relationship (Consultant or Advisor (Oncology)) with Pacifice Edge Diagnostics;.
has a financial relationship (Consultant or Advisor (Oncology)) with Astellas Pharma, Inc.;.
has a financial relationship (Consultant or Advisor (Oncology)) with Myovant Sciences;.
has a financial relationship (Consultant or Advisor (Oncology)) with Prokarium;.
has a financial relationship (Consultant or Advisor (Oncology)) with Pfizer;.
has a financial relationship (Consultant or Advisor (Oncology)) with Bayer Healthcare Pharmaceuticals;.

Elisabeth Heath,

has a financial relationship (Scientific Study or Trial (Specialty Not Specified)) with Oncolys;.
has a financial relationship (Consultant or Advisor (Specialty Not Specified)) with Seattle Genetics;.
has a financial relationship (Meeting Participant or Lecturer (Specialty Not Specified)) with Zenith;.
has a financial relationship (Scientific Study or Trial (Specialty Not Specified)) with Merck;.
has a financial relationship (Scientific Study or Trial (Specialty Not Specified)) with Agensys;.
has a financial relationship (Consultant or Advisor (Specialty Not Specified)) with Sanofi;.

Daniel Parker, MD

has a financial relationship (Consultant or Advisor (Oncology)) with Photocure;.

METHOD OF PARTICIPATION:

Participants receive 5 lessons per month for 8 months for a total of 40 lessons. Each lesson is designated for a maximum of 1.0 AMA PRA Category 1 Credit™. To earn credit, participants must read the educational material provided for each lesson, pass its corresponding online posttest with at least 80% accuracy, submit the online evaluation and claim CME.

ACCREDITATION:

The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CREDIT DESIGNATION:

The American Urological Association designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

OTHER LEARNERS:

The AUA is not accredited to offer credit to participants who are not MDs or DOs. However, the AUA will issue documentation of participation that states that the activity was certified for AMA PRA Category 1 Credit™.

EVIDENCE BASED CONTENT:

It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias.

AUA DISCLOSURE POLICY: 

All persons in a position to control the content of an educational activity (i.e., activity planners, presenters, authors) are required to disclose to the provider all financial relationships with any commercial interest during the previous 24 months. The AUA must determine if the individual’s relationships may influence the educational content and mitigate any conflicts of interest prior to the commencement of the educational activity. The intent of this disclosure is not to prevent individuals with relevant financial relationships from participating, but rather to provide learners information with which they can make their own judgments.

MITIGATION OF IDENTIFIED CONFLICT OF INTEREST:

All disclosures will be reviewed by the AUA Conflict of Interest (COI) Review Work Group Chair and/or Vice Chair for identification of conflicts of interest. The AUA COI Review Work Group, working with Office of Education staff, will document the mechanism(s) for management and mitigation of the conflict of interest and final approval of the activity will be documented prior to implementation. Any of the mechanisms below can/will be used to mitigate conflict of interest:

  • Peer review for valid, evidence-based content by the AUA COI Review Work Group.
  • Attestation that clinical recommendations are evidence-based and free of commercial bias.
  • Introduction of a debate format (point-counterpoint)
  • Inclusion of moderated panel discussion with unbiased moderator
  • Publication of a parallel or rebuttal article for an article that is felt to be biased
  • Divestiture of the relationship by faculty
  • Recusal from controlling relevant aspects of planning
  • Selection of alternative faculty for specific topic

OFF-LABEL OR UNAPPROVED USE OF DRUGS OR DEVICES:

The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the prescribing information for full disclosure of approved uses.

AUA PARTICIPANT INFORMATION & POLICIES

DISCLAIMER:

The opinions and recommendations expressed by faculty, authors and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the AUA.

CONSENT TO USE OF PHOTOGRAPHIC IMAGES:

Attendance at or participation in AUA meetings and other activities constitutes an agreement by the registrant to AUA's use and distribution (both now and in the future) of the attendee's image or voice in photographs and electronic reproductions of such meetings and activities.

AUDIO, VIDEO, AND PHOTOGRAPHIC EQUIPMENT: 

The use of audio, video and other photographic recording equipment by attendees is prohibited inside AUA meeting rooms.

REPRODUCTION PERMISSION:

Reproduction of written materials developed for this AUA course is prohibited without the written permission from individual authors and the American Urological Association.

Released date: April, 2023
Expiration date: April, 2026

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Non-Physician Participation
Please login or register to take this course.

FACULTY DISCLOSURES AND ACCREDITATION

For specific faculty disclosure and accreditation information about this lesson, please go to the Faculty and Accreditation tabs.