Trimodality Therapy for Management of Muscle Invasive Bladder Cancer Webcast (2021)

This course is a comprehensive review of tri-modal therapy for muscularis propria invasive urothelial carcinoma of the bladder with a multidisciplinary faculty including urology, radiation oncology, and medical oncology. We will review results from prospective randomized trials and large institutional experiences in tri-modality bladder sparing therapy. The course will focus on the Urologist's critical role in patient selection for this approach vs. radical cystectomy. We will discuss the technique and importance of aggressive transurethral resection and repeat resection prior to proceeding to chemotherapy and radiation, as well as the continued role of the urologist in repeat cystoscopic assessments of tumor response and ongoing surveillance of the bladder. We will review the coordinated multidisciplinary approach for bladder preservation, including radiation fields, role of concurrent chemotherapy, need for early salvage cystectomy when indicated, as well as management of non-muscle invasive recurrences. We will review potential toxicities and quality of life associated with bladder sparing therapy versus cystectomy, and will address emerging topics such as novel biomarkers and the potential role of combining radiation with immunotherapy and other targeted therapies. Our course will also feature a patient advocate who will be able to comment on the direct patient experience with tri-modal therapy for muscle invasive bladder cancer.



Support provided by independent educational grants from AstraZeneca, Bristol Myers Squibb and Merck.

Target Audience

  • Urologists
  • Residents
  • Advanced Practice Providers (Nurse Practitioners and Physician Assistants)

Learning Objectives

At the conclusion of the activity, participants will be able to:

  1. Demonstrate an understanding of prospective randomized trials and large institutional experiences in tri-modality therapy for muscularis propria invasive bladder cancer.
  2. Identify which patients are candidates for tri-modal bladder sparing therapy, and which patients are not candidates and should instead undergo radical cystectomy.
  3. Explain the technique and importance of aggressive initial transurethral resection, repeat transurethral resection and ongoing cystoscopic surveillance of the bladder.
  4. Outline the coordinated multidisciplinary technique in tri-modality therapy, including radio-sensitizing chemotherapy agents, radiation fields, and adjuvant chemotherapy.
  5. Describe the indications for salvage cystectomy, discuss management of noninvasive recurrences, and understand the quality of life and potential toxicities after tri-modal therapy.
Course summary
Available credit: 
  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 Non-Physician Participation
Course opens: 
Course expires: 

Education Council Disclosures

PDF icon Education Council Disclosures 2021

COI Review Work Group Disclosures

PDF icon COI Review Work Group Disclosures 2021

All relevant financial relationships have been mitigated. 

AUA Office of Education Staff has nothing to disclose.

Course Director(s)

Adam Feldman, MD, MPH

has a financial relationship (Independent contractor) with Vessi Medical;.
has a financial relationship (Independent contractor) with Olympus America, Inc;.
has a financial relationship (Other) with Janssen Pharmaceuticals;.

Jason Efstathiou, MD, PHD

has a financial relationship (Independent contractor) with Myovant Sciences;.
has a financial relationship (Independent contractor) with BlueEarth Diagnostics;.
has a financial relationship (Independent contractor) with Progenics;.
has a financial relationship (Independent contractor) with AstraZeneca Pharmaceuticals;.
has a financial relationship (Independent contractor) with Boston Scientific;.
has a financial relationship (Independent contractor) with Merck;.
has a financial relationship (Independent contractor) with Uptodate;.

Richard Lee, MD

has a financial relationship (Other) with Janssen LLC;.


Learners will participate in this online educational activity by viewing the webcast and/or listening to the podcast and completing the post-test and evaluation. To claim CME credit for this enduring material, learners must complete the post-test, passing with 80% accuracy, and submit the program evaluation.

Estimated time to complete this activity: 2.00 hours

Release Date: May, 2021
Expiration Date: March, 2022


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


The American Urological Association designates this enduring material for a maximum of 2.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


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™.


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.


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 any relevant financial relationships with any commercial interest. The AUA must determine if the individual’s relationships may influence the educational content and resolve 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.


All disclosures will be reviewed by the AUA Conflict of Interest (COI) Review Work Group for identification of conflicts of interest. The AUA COI Review Work Group, working with the program directors and/or editors, will document the mechanism(s) for management and resolution 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 resolve conflict of interest:

  • Peer review for valid, evidence-based content of all materials associated with an educational activity by the course/program director, editor, and/or AUA COI Review Work Group.
  • Limit content to evidence with no recommendations
  • Introduction of a debate format with an unbiased moderator (point-counterpoint)
  • Inclusion of moderated panel discussion
  • Publication of a parallel or rebuttal article for an article that is felt to be biased
  • Limit equipment representatives to providing logistics and operation support only in procedural demonstrations
  • Divestiture of the relationship by faculty


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.

Available Credit

  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 Non-Physician Participation
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