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ForwardUpper-Tract Urothelial Cancer Guidelines: An Interactive and Evidence-based Course Highlighting the Full Spectrum of Disease via Case Discussion and Video Presentation Webcast (2023)
This course will walk through the newly developed AUA Guidelines for Upper Tract Urothelial Cancer (UTUC) using an interactive discussion of complex cases with attendee involvement to enhance their knowledge of this challenging disease and provide a basis for practice improvement. Aspects such as optimizing initial workup and risk stratification, endoscopic techniques for biopsy and treatment, multidisciplinary management (e.g., coordinating with medical oncology, nephrology, genetic counseling) and nuances of surgical approaches will be stressed. Presentations will include video demonstrations of surgical techniques for endoscopic, robotic and open approaches. Point and counterpoint discussions among panelists will highlight controversies in management. New/emerging therapies and technologies such as topical and laser-based treatments will be covered including management of complications and follow-up strategies.
ACKNOWLEDGEMENTS
Independent educational grant support provided by:
- AstraZeneca
- Merck & Co., Inc.
- Pfizer, Inc.
Learning Objectives
At the conclusion of this activity, participants will be able to:
- Apply a standardized approach to optimally evaluate and diagnose patients with UTUC, including the interpretation of imaging features, appropriate use and documentation of endoscopic findings, and tissue sampling techniques to better standardize patient care and reliably allow for disease risk stratification while minimizing potential for patient harms.
- Identify pre-surgical risk features shown to be associated with aggressive disease biology (e.g., progression, metastasis) and medical comorbidities (e.g., renal dysfunction, neuropathy, smoking, hereditary factors, etc.) to be addressed as part of comprehensive patient care, and how to incorporate these features when counseling patients on therapeutic options.
- Describe the rationale, evidence and appropriate scenarios for recommending neoadjuvant or adjuvant therapy for patients with UTUC as well as the expected side effects and impact on surgical management.
- Explain the scenarios for considering organ-sparing management, describing all available options including the indications and appropriate application of topical therapies, endoscopic treatment approaches and segmental resection as well as associated limitations, complications and how to mitigate these events.
- Describe the data on the oncologic impact of lymph node dissection at the time of nephroureterectomy, patterns of lymph node metastasis associated with anatomical location of UTUC tumors and the implications for templates of staging lymphadenectomy as part of surgical management.
FACULTY DISCLOSURES:
| Name | Company Name | Relationship Type | End Date |
| Jean H. Hoffman-Censits, MD | Seattle Genetics | Consultant or Advisor | Current |
| Foundation Medicine | Consultant or Advisor | Current | |
| Astra-Zeneca | Consultant or Advisor | Current | |
| Genentech | Scientific Study or Trial | Current | |
| Gilead Sciences Inc | Consultant or Advisor | Current | |
| Jonathan Andrew Coleman, MD | None | ||
| Hong Truong, MD, MS | None | ||
| Jay D. Raman, MD, FACS | None |
EDUCATION COUNCIL DISCLOSURES:
Education Council Disclosures_2022.pdf
COI REVIEW WORKGROUP DISCLOSURES:
COI Review Work Group Disclosures_2023_0.pdf
AUA Office of Education Staff has nothing to disclose.
All relevant financial relationships have been mitigated.
METHOD OF PARTICIPATION:
Learners will participate in this online educational activity by view the webcast 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, 2023
Expiration Date: May, 2024
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 2.00 AMA PRA Category 1 Credit™. 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 (aka ineligible company) 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.
Available Credit
- 2.00 AMA PRA Category 1 Credit™
- 2.00 Non-Physician Participation