Stage IVa (cT4b, AnyN, M0; Any T, Any N, M1a)

Question 1

M1a means?

Answer 1

DISTANT METASTASIS LIMITED TO LYMPH NODES BEYOND COMMON ILIAC

Question 2

cT4b means?

Answer 2

EXTRAVESICAL TUMOR INVADING THE PELVIC WALL AND ABDOMINAL WALL

Question 3

4 additional work ups?

Answer 3

ABC plus genomic testing/molecular testing

Question 4

Categorize patients into 2 entities, which are?

Answer 4

M0 disease and M1a disease

Question 5

For M0 disease, what are the TWO primary treatment options?

Answer 5

Systemic therapy or concurrent chemoradiotherapy

Question 6

For M1a disease, what is the primary treatment option?

Answer 6

Systemic therapy only

Question 7

Post systemic therapy for M0 disease, how many cycles will you complete before reassessment?

Answer 7

2-3 cycles

Question 8

On reassessment post systemic therapy in M0 disease, what are your FOUR tools for reassessment?

Answer 8

Cystoscopy
EUA
TURBT
Abdominopelvic imaging

Question 9

In M0 disease, post systemic therapy or concurrent chemorad, and reassessment, tumor or no tumor, what are your THREE subsequent treatment options? With tumor has no “consolidation” term for which subsequent treatment.

Answer 9

Consolidation SYSTEMIC THERAPY OR CHEMORAD AND/OR CYSTECTOMY

Question 10

In M1a disease post systemic therapy, complete resolution was seen, what are your TWO options for subsequent treatment?

Answer 10

CONCURRENT CHEMORAD OR CYSTECTOMY

Question 11

cT4a means?

Answer 11

EXTRAVESICAL TUMOR AFFECTING THE PS, SV, Uterus, Vagina