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Oligometastatic Prostate cancer

OMPC considered to have 3-5 metastatic lesions.

An abscopal effect may be beneficial in patients with metastatic disease, when the primary tumor is treated.

A proposed biological mechanism for improved clinical outcomes with local therapy is the reduction of total tumor burden, where  higher tumor burden is associated with greater expression of cancer stem cell markers.

Information is evolving to understand that OMPC may be amenable to local therapy.

Prospective trials have demonstrated a greatest survival benefit when local therapies combined with systemic therapy than when systemic therapy is given alone.

Randomized controlled studies found that local radiation does not improve overall survival in patients with high volume metastatic prostate cancer but may improve overall survival in patients with low value metastatic prostate cancer.

Episodes of tumor regression in distal sites  have been reported in cryoablation and radiation therapy for local disease.

Multi centered randomized trials found that local radiation therapy did not improve overall survival in patients with high volume metastatic prostate cancer but may improve overall survival in patients with low-volume metastatic prostate cancer.

Studies are underway to evaluate prostatectomy or radiation to the prostate in the presence of metastatic disease.

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