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Treatment Options in Oligometastatic Disease in Prostate Cancer: Thinking Outside the Box

  • Genitourinary Cancers (S Gupta, Section Editor)
  • Published:
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Opinion statement

Due to its relatively indolent disease course, the sensitivity of PSA testing, and the emergence of novel PET imaging, metastatic prostate cancer is particularly likely to present with a limited volume of disease. Patients with up to five metastatic lesions should be considered for an oligometastatic treatment approach. Systemic therapy remains the cornerstone of treatment for these patients. The optimal type and duration are unknown; however, the addition of a second agent to ADT appears to be beneficial. Multiple recent studies have found significant benefits to the integration of systemic therapy and local metastasis-directed therapies (MDT), including radiation and surgery, to the prostate and metastatic sites. MDT may also be used in select patients wishing to delay the initiation of systemic therapy. For patients with isolated regional nodal recurrences, whole pelvic radiotherapy or extensive lymphadenectomy is preferred, in combination with ADT.

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Authors and Affiliations

  1. Department of Radiation Oncology, Cleveland Clinic Foundation, Taussig Cancer Institute, 9500 Euclid Avenue/CA-50, Cleveland, OH, 44195, USA

    Christopher W Fleming MD, James R Broughman MD & Rahul D Tendulkar MD

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  1. Christopher W Fleming MD
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Correspondence to Christopher W Fleming MD.

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Christopher W. Fleming declares that he has no conflict of interest. James R. Broughman declares that he has no conflict of interest. Rahul D. Tendulkar has received honoraria for educational talks from Varian Medical Systems.

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Fleming, C.W., Broughman, J.R. & Tendulkar, R.D. Treatment Options in Oligometastatic Disease in Prostate Cancer: Thinking Outside the Box. Curr. Treat. Options in Oncol. 22, 2 (2021). https://doi.org/10.1007/s11864-020-00798-w

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