Stage IIIB (cT1-T4a, N2-N3)

Question 1

N2 means?

Answer 1

MULTIPLE POISE (PERIVESICAL, OBTURATOR, INTERNAL ILIAC, SACRAL, EXTERNAL ILIAC)

Question 2

N3 means?

Answer 2

COMMON ILIAC LN

Question 3

Additional workup for these patients include ABC, what is the special testing that you will consider adding?

Answer 3

MOLECULAR/GENOMIC TESTING SUCH AS FGFR2 FGFR3

Question 4

What are the TWO PRIMARY TREATMENT OPTIONS?

Answer 4

DOWNSTAGING SYSTEMIC THERAPY
AND
CONCURRENT CHEMORAD

Question 5

After DOWNSTAGING SYSTEMIC THERAPY, when will you reassess tumor status post treatment?

Answer 5

2-3 MONTHS AFTER FULL TREATMENT (ABC ULIT THEN CYSTOSCOPY IF NEGATIVE ON IMAGING)

Question 6

What are the responses that you will categorize your patient into in both treatment options?

Answer 6

COMPLETE RESPONSE, PARTIAL RESPONSE, PROGRESSION

Question 7

After DOWNSTAGING SYSTEMIC THERAPY, a complete response was seen, what are your subsequent treatment options? There are three.

Answer 7

CONSOLIDATION CYSTECTOMY
CONSOLIDATION CHEMORADIOTHERAPY
OR OBSERVATION

Question 8

After DOWNSTAGING SYSTEMIC THERAPY, a partial response was seen, what are your subsequent treatment options? There are three.

Answer 8

CYSTECTOMY
CHEMORADIOTHERAPY
TREAT AS METASTATIC DISEASE

Question 9

After CONCURRENT CHEMORAD, when will you reassess tumor status post treatment?

Answer 9

2-3 MONTHS AFTER FULL TREATMENT

Question 10

After CONCURRENT CHEMORAD, a complete response was seen, what is your next step?

Answer 10

FOLLOW UP

Question 11

After CONCURRENT CHEMORAD, a partial response was seen, what are the three scenarios?

Answer 11

IF TIS, TA, T1 - MAY CONSIDER INTRAVESICAL BCG
SURGICAL CONSOLIDATION
TREAT AS METASTATIC DISEASE