Oligometastatic prostate cancer — bridging the gap between localized and metastatic disease

Surveillance Epidemiology and End Results Program (SEER). Cancer Stat Facts: Prostate Cancer. https://seer.cancer.gov/statfacts/html/prost.html (2024).

Eastham, J. A. et al. Clinically localized prostate cancer: AUA/ASTRO guideline, part I: introduction, risk assessment, staging, and risk-based management. J. Urol. 208, 10–18 (2022).

Article  PubMed  Google Scholar 

EAU Guidelines. Presented at the EAU Annual Congress Madrid 2025. https://uroweb.org/guidelines/prostate-cancer (2026).

D’Amico, A. V. et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280, 969–974 (1998).

Article  PubMed  Google Scholar 

Dee, E. C. et al. Prostate cancer-specific mortality burden by risk group among men with localized disease: implications for research and clinical trial priorities. Prostate 80, 1128–1133 (2020).

Article  PubMed  Google Scholar 

National Comprehensive Cancer Network. Prostate Cancer (Version 2.2026) https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459 (2025).

Sormani, M. P. The Will Rogers phenomenon: the effect of different diagnostic criteria. J. Neurol. Sci. 287 (Suppl. 1), 46–49 (2009).

Article  Google Scholar 

Hoffmann, M. A. et al. Pretreatment PSMA PET in prostate cancer patients without metastases by conventional imaging changes primary stage and treatment: a systematic review and meta-analysis. J. Surg. 10, 11247 (2025).

Google Scholar 

Hellman, S. & Weichselbaum, R. R. Oligometastases. J. Clin. Oncol. 13, 8–10 (1995).

Article  CAS  PubMed  Google Scholar 

Tosoian, J. J. et al. Oligometastatic prostate cancer: definitions, clinical outcomes, and treatment considerations. Nat. Rev. Urol. 14, 15–25 (2017).

Article  CAS  PubMed  Google Scholar 

Francini, E. et al. Time of metastatic disease presentation and volume of disease are prognostic for metastatic hormone sensitive prostate cancer (mHSPC). Prostate 78, 889–895 (2018).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Wenzel, M. et al. Impact of time to metastatic disease onset and extent of disease volume across metastatic hormone-sensitive and castration-resistant prostate cancer. Urol. Oncol. 42, 371.e11–371.e18 (2024).

Article  CAS  PubMed  Google Scholar 

Gravis, G. et al. Burden of metastatic castrate naive prostate cancer patients, to identify men more likely to benefit from early docetaxel: further analyses of CHAARTED and GETUG-AFU15 studies. Eur. Urol. 73, 847–855 (2018).

Article  PubMed  PubMed Central  Google Scholar 

Deek, M. P. et al. The mutational landscape of metastatic castration-sensitive prostate cancer: the spectrum theory revisited. Eur. Urol. 80, 632–640 (2021).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Petrelli, F. et al. Better survival of patients with oligo- compared with polymetastatic cancers: a systematic review and meta-analysis of 173 studies. F1000Res 10, 423 (2021).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Weichselbaum, R. R. & Hellman, S. Oligometastases revisited. Nat. Rev. Clin. Oncol. 8, 378–382 (2011).

Article  CAS  PubMed  Google Scholar 

Berkovic, P. et al. Salvage stereotactic body radiotherapy for patients with limited prostate cancer metastases: deferring androgen deprivation therapy. Clin. Genitourin. Cancer 11, 27–32 (2013).

Article  PubMed  Google Scholar 

Decaestecker, K. et al. Repeated stereotactic body radiotherapy for oligometastatic prostate cancer recurrence. Radiat. Oncol. 9, 135 (2014).

Article  PubMed  PubMed Central  Google Scholar 

(POPSTAR) A pilot study of patients with oligometastases from prostate cancer treated with stereotactic ablative body radiosurgery. ANZCTR https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363885 (2013).

Decaestecker, K. et al. Surveillance or metastasis-directed therapy for oligometastatic prostate cancer recurrence (STOMP): study protocol for a randomized phase II trial. BMC Cancer 14, 671 (2014).

Article  PubMed  PubMed Central  Google Scholar 

Radwan, N. et al. A phase II randomized trial of observation versus stereotactic ablative radiation for oligometastatic prostate cancer (ORIOLE). BMC Cancer 17, 453 (2017).

Article  PubMed  PubMed Central  Google Scholar 

Ahmed, K. A. et al. Stereotactic body radiation therapy in the treatment of oligometastatic prostate cancer. Front. Oncol. 2, 215 (2012).

PubMed  Google Scholar 

Palma, D. A. et al. Stereotactic ablative radiotherapy for comprehensive treatment of oligometastatic tumors (SABR-COMET): study protocol for a randomized phase II trial. BMC Cancer 12, 305 (2012).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Olson, R. et al. Population-based phase II trial of stereotactic ablative radiotherapy (SABR) for up to 5 oligometastases: SABR-5. BMC Cancer 18, 954 (2018).

Article  PubMed  PubMed Central  Google Scholar 

Francolini, G. et al. PERSIAN trial (NCT05717660): an ongoing randomized trial testing androgen deprivation therapy, apalutamide and stereotactic body radiotherapy. An alternative “triplet” for oligometastatic hormone sensitive prostate cancer patients. Med. Oncol. 41, 39 (2023).

Article  PubMed  Google Scholar 

Tang, C. et al. Addition of metastasis-directed therapy to intermittent hormone therapy for oligometastatic prostate cancer: the extend phase 2 randomized clinical trial. JAMA Oncol. 9, 825–834 (2023).

Article  PubMed  PubMed Central  Google Scholar 

Sweeney, C. J. et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N. Engl. J. Med. 373, 737–746 (2015).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Parker, C. C. et al. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial. Lancet 392, 2353–2366 (2018).

Article  PubMed  PubMed Central  Google Scholar 

Kyriakopoulos, C. E. et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial. J. Clin. Oncol. 36, 1080–1087 (2018).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ali, A. et al. Association of bone metastatic burden with survival benefit from prostate radiotherapy in patients with newly diagnosed metastatic prostate cancer: a secondary analysis of a randomized clinical trial. JAMA Oncol. 7, 555–563 (2021).

Article  PubMed  PubMed Central  Google Scholar 

Phillips, R. et al. Outcomes of observation vs stereotactic ablative radiation for oligometastatic prostate cancer: the oriole phase 2 randomized clinical trial. JAMA Oncol. 6, 650–659 (2020).

Article  PubMed  PubMed Central  Google Scholar 

Ost, P. et al. Surveillance or metastasis-directed therapy for oligometastatic prostate cancer recurrence: a prospective, randomized, multicenter phase II trial. J. Clin. Oncol. 36, 446–453 (2018).

Article  CAS  PubMed  Google Scholar 

Marvaso, G. et al. ADT with SBRT versus SBRT alone for hormone-sensitive oligorecurrent prostate cancer (RADIOSA): a randomised, open-label, phase 2 clinical trial. Lancet Oncol. 26, 300–311 (2025).

Article  CAS  PubMed  Google Scholar 

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/study/NCT02264379 (2023).

See, A. W. et al. Five-year outcomes of fractionated stereotactic body radiotherapy for oligometastatic prostate cancer from the TRANSFORM phase II trial. Int. J. Cancer 155, 1248–1256 (2024).

Article  CAS  PubMed  Google Scholar 

Privé, B. M. et al. Lutetium-177-PSMA-617 in oligo-metastatic hormone sensitive prostate cancer (BULLSEYE trial). J. Clin. Oncol. 43, 5009 (2025).

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