Michael S. Cookson, MD, MMHC, presented “A Review of AUA/SUO/ASTRO Guidelines for MIBC” during the International Bladder Cancer Update 2021 virtual conference in April 2021.

How to cite: Cookson, Michael S. “A Review of AUA/SUO/ASTRO Guidelines for MIBC” April 2021. Accessed Jul 2024. https://grandroundsinurology.com/a-review-of-aua-suo-astro-guidelines-for-mibc/

A Review of AUA/SUO/ASTRO Guidelines for MIBC – Summary:

Michael S. Cookson, MD, MMHC, Professor and Chairman of the Department of Urology at the University of Oklahoma Health Sciences Center, summarizes the updated AUA/SUO/ASTRO guideline for  the treatment of muscle-invasive bladder cancer (MIBC). He considers the purpose of the guideline, noting that MIBC conveys a significant risk of death which has not changed in decades, and the  critical importance of having a risk-stratified framework for managing this disease. Dr. Cookson then outlines the methodology behind the guideline, noting that recommendations are stratified based on A-, B-, and C-level evidence, with A-level evidence leading to the strongest recommendations, and C-level evidence leading to the most conditional recommendations. Following  this, he reviews the guideline’s recommendations for initial patient evaluation and counseling, chemotherapy, radical cystectomy, urinary diversion, perioperative management, pelvic lymphadenectomy, patient selection for bladder preservation, treatment with maximal transurethral resection of the bladder tumor and partial cystectomy, primary radiation therapy, multimodal bladder preserving therapy, treatment failure in patients who underwent bladder preservation therapy, and surveillance and follow-up. Dr. Cookson makes a particular note of current research that may affect some of these guidelines in the near future, such as multiple clinical trials looking at chemotherapy, the latest evidence in the debate over the potential benefits of extended pelvic lymphadenectomy, and a study considering the value of bladder preservation. He concludes by referring clinicians to the treatment algorithm included in the guideline.

About the International Bladder Cancer Update 2021 virtual conference:
The International Bladder Cancer Update (IBCU) is a CME conference focused on the diagnosis and treatment of bladder cancer. The conference offers medical professionals an opportunity to listen to updates from, and interact with, expert international faculty to improve knowledge and determine best treatment practices to improve patient outcomes. IBCU encompasses expert lectures, interactive discussions, a panel roundtable, debates, and case presentations. It is physician-led, multi-supported, and designed for urologists, urologic oncologists, and other healthcare professionals involved in the treatment of bladder cancer.



Michael S. Cookson, MD, MMHC, is Professor and Chairman of the Department of Urology and holds the Donald D. Albers Endowed Chair in Urology at the University of Oklahoma Health Sciences Center in Oklahoma City. He has authored some 240 peer-reviewed journal publications as well as more than 30 chapters of various textbooks, and he is nationally recognized for his outstanding contributions to urologic oncology. Dr. Cookson completed his Urology Residency at the University of Texas, San Antonio, and completed his Urologic Oncology Fellowship at Memorial Sloan-Kettering Cancer Center in New York. From 1998 to 2013, he served as the Vice Chairman of Urologic Surgery and Director of the Urologic Oncology Fellowship Program at Vanderbilt University. Dr. Cookson has devoted much of his academic career to the management of patients with urologic cancers, with a strong emphasis on clinical guidelines, education, and evidenced-based medicine. He was a member of the AUA/ABU Examination Committee for 10 years, serving as Oncology Consultant and Pathology Editor. He also serves on the ABU Oral Examination Committee. He is a Co-Founder of the Oncology Knowledge Assessment Test (OKAT), an SUO-mandated examination. He also served as Chair for the OKAT for 5 years. In 2011, he received the President’s Distinguished Service Award from the SUO for educational contributions. He received the 2018 AUA Presidential Citation for Outstanding Service for his role in the development of the OKAT and as Chair of the Castration-Resistant Prostate Cancer Guidelines Committee at the AUA 2018 Annual Meeting. Dr. Cookson has previously served as a member of the AUA Guidelines on Localized Prostate Cancer Committee. Dr. Cookson is currently serving out the 2019-2020 term as the SUO President.