Oligometastatic Prostate Cancer

Authors: J. Navrátil 1,2;  A. Poprach 1,2;  R. Lakomý 1,2;  I. Kocák 1,2;  J. Vašina 2,3;  P. Krupa 2,4;  R. Vyzula 1,2
Authors‘ workplace: Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno 1;  LF MU, Brno 2;  Oddělení nukleární medicíny, Masarykův onkologický ústav, Brno 3;  Klinika radiační onkologie, Masarykův onkologický ústav, Brno 4
Published in: Klin Onkol 2019; 32(2): 97-100
Category: Review
doi: 10.14735/amko201997



With advancements in diagnostic techniques, oligometastatic prostate cancer is diagnosed in patients who were, in the past, considered to have localized disease. Moreover, evidence of the effectiveness of treatment intensification for this disease is increasing, focusing on primary tumors as well as metastatic lesions. Thus, we can delay the start of systemic palliative treatment and improve overall survival. Many questions remain unclear, such as the definition of oligometastasis disease, or which patients should be offered aggressive treatment. Data are limited and come from small retrospective studies but show conclusively the benefits of survival in targeted primary prostate and metastatic prostate cancer therapy with surgery or radiotherapy. Often, stereotactic radiotherapy is used in this indication, with minimal side effects. In retrospective studies, 3–5 metastatic lesions were generally accepted for definition of oligometastatic disease, but patient subgroups were heterogeneous. A recent study attempts to better define oligometastatic disease and find out the right degree of intensification of treatment. When and in which patient to use metastasis-targeted therapy and when the standard systemic treatment is already meaningful. It is already clear that selected patients benefit from targeted personalized treatment.


The purpose of this review is to offer an update of the problem of oligometastatic prostate cancer. The article presents an overview of data from contemporary literature, modern possibilities of diagnostic imaging methods and treatment options of oligometastatic prostate cancer including surgery and radiotherapy.

 authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted: 8. 2. 2019

Accepted: 5. 3. 2019


prostate cancer – oligometastatic disease – prostatectomy – radiotherapy – androgen-deprivation therapy – PET/CT


1. Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol 1995; 13 (1): 8–10. doi: 10.1200/JCO.1995.13.1.8.

2. Uppal A, Ferguson MK, Posner MC et al. Towards a molecular basis of oligometastatic disease: potential role of micro-RNAs. Clin Exp Metastasis 2014; 31 (6): 735–748. doi: 10.1007/s10585-014-9664-3.

3. Haffner MC, Mosbruger T, Esopi DM et al. Tracking the clonal origin of lethal prostate cancer. J Clin Invest 2013; 123 (11): 4918–4922. doi: 10.1172/JCI70354.

4. James ND, Spears MR, Clarke NW et al. Failure-free survival and radiotherapy in patients with newly diagnosed nonmetastatic prostate cancer: data from patients in the control arm of the STAMPEDE Trial. JAMA Oncol 2016; 2 (3): 348–357. doi: 10.1001/jamaoncol.2015.4350.

5. Tward JD, Kokeny KE, Shrieve DC. Radiation therapy for clinically node-positive prostate adenocarcinoma is correlated with improved overall and prostate cancer-specific survival. Pract Radiat Oncol 2013; 3 (3): 234–240. doi: 10.1016/j.prro.2012.11.011.

6. Frohmüller HG, Theiss M, Manseck A et al. Survival and quality of life of patients with stage D1 (T1-3 pN1-2 M0) prostate cancer. Radical prostatectomy plus androgen deprivation versus androgen deprivation alone. Eur Urol 1995; 27 (3): 202–206.

7. Moschini M, Sharma V, Zattoni F et al. Risk stratification of pN+ prostate cancer after radical prostatectomy from a large single institutional series with longterm followup. J Urol 2016; 195 (6): 1773–1778. doi: 10.1016/j.juro.2015.12.074.

8. Heidenreich A, Pfister D, Porres D. Cytoreductive radical prostatectomy in patients with prostate cancer and low volume skeletal metastases: results of a feasibility and case-control study. J Urol 2015; 193 (3): 853–855. doi: 10.1016/j.juro.2015.02.2952.

9. Ploussard G, Almeras C, Briganti A et al. Management of node only recurrence after primary local treatment for prostate cancer: a systematic review of the literature. J Urol 2015; 194 (4): 983–988. doi: 10.1016/j.juro.2015.04.103.

10. Jereczek-Fossa BA, Fariselli L, Beltramo G et al. Linac-based or robotic image-guided stereotactic radiotherapy for isolated lymph node recurrent prostate cancer. Radiother Oncol 2009; 93 (1): 14–17. doi: 10.1016/j.radonc.2009.04.001.

11. Muacevic A, Kufeld M, Rist C et al. Safety and feasibility of image-guided robotic radiosurgery for patients with limited bone metastases of prostate cancer. Urol Oncol 2013; 31 (4): 455–460. doi: 10.1016/j.urolonc.2011.02. 023.

12. Decaestecker K, De Meerleer G, Lambert B et al. Repeated stereotactic body radiotherapy for oligometastatic prostate cancer recurrence. Radiat Oncol 2014; 9: 135. doi: 10.1186/1748-717X-9-135.

13. Burkoň P, Slávik M, Kazda T et al. Extrakraniální stereotaktická radioterapie – přehled současných indikací. Klin Onkol 2019; 32 (1): 10–24. doi: 10.14735/amko201910.

14. Koo KC, Dasgupta P. Treatment of oligometastatic hormone-sensitive prostate cancer: a comprehensive review. Yonsei Med J 2018; 59 (5): 567–579. doi: 10.3349/ymj.2018.59.5.567.

15. Ahmad AE, Leão R, Hamilton RJ. Radical prostatectomy for patients with oligometastatic prostate cancer. Oncology (Williston Park) 2017; 31 (11): 794–802.

16. Ahmed KA, Barney BM, Davis BJ et al. Stereotactic body radiation therapy in the treatment of oligometastatic prostate cancer. Front Oncol 2013; 2: 215. doi: 10.3389/fonc.2012.00215.

17. Berkovic P, De Meerleer G, Delrue L et al. Salvage stereotactic body radiotherapy for patients with limited prostate cancer metastases: deferring androgen deprivation therapy. Clin Genitourin Cancer. 2013; 11: 27–32. doi: 10.1016/j.clgc.2012.08.003.

18. Jereczek-Fossa BA, Piperno G, Ronchi S et al. Linac-based stereotactic body radiotherapy for oligometastatic patients with single abdominal lymph node recurrent cancer. Am J Clin Oncol 2014; 37: 227–233. doi: 10.1097/COC.0b013e3182610878.

19. Ost P, Jereczek-Fossa BA, As NV et al. Progression-free survival following stereotactic body radiotherapy for oligometastatic prostate cancer treatment-naive recurrence: a multi-institutional analysis. Eur Urol 2016; 69: 9–12. doi: 10.1016/j.eururo.2015.07.004.

20. Ponti E, Ingrosso G, Carosi A et al. Salvage stereotactic body radiotherapy for patients with prostate cancer with isolated lymph node metastasis: a singlecenter experience. Clin Genitourin Cancer 2015; 13: e279–e284. doi: 10.1016/j.clgc.2014.12.014.

21. Schick U, Jorcano S, Nouet P et al. Androgen deprivation and high-dose radiotherapy for oligometastatic prostate cancer patients with less than five regional and/or distant metastases. Acta Oncol 2013; 52: 1622–1628. doi: 10.3109/0284186X.2013.764010.

22. Singh D, Yi WS, Brasacchio RA, et al. Is there a favorable subset of patients with prostate cancer who develop oligometastases? Int J Radiat Oncol Biol Phys 2004; 58: 3–10.

23. Tabata K, Niibe Y, Satoh T et al. Radiotherapy for oligometastases and oligo-recurrence of bone in prostate cancer. Pulm Med 2012; 2012: 541656. doi: 10.1155/2012/541656.

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