Progress in Oligometastatic Prostate Cancer: Emerging Imaging Innovations and Therapeutic Approaches

Simple Summary In recent years, there has been growing interest in oligometastatic prostate cancer (PCa). Unlike more widespread forms of the disease, oligometastatic PCa involves only a limited number of cancerous lesions in specific areas of the body. This review delves into the latest advancements in our understanding of oligometastatic PCa, including how it works on a biological level, the use of advanced imaging techniques to spot it, and the various treatment approaches being explored. For patients with this intermediate-stage cancer, there is hope on the horizon, as personalized treatments such as surgery and targeted radiation therapy are showing promise. The findings from ongoing research may ultimately lead to better outcomes for individuals facing this unique challenge, bridging the gap between localized and widespread PCa.Abstract Prostate cancer (PCa) exhibits a spectrum of heterogeneity, from indolent to highly aggressive forms, with approximately 10-20% of patients experiencing metastatic PCa. Oligometastatic PCa, characterized by a limited number of metastatic lesions in specific anatomical locations, has gained attention due to advanced imaging modalities. Although patients with metastatic PCa typically receive systemic therapy, personalized treatment approaches for oligometastatic PCa are emerging, including surgical and radiotherapeutic interventions. This comprehensive review explores the latest developments in the field of oligometastatic PCa, including its biological mechanisms, advanced imaging techniques, and relevant clinical studies. Oligometastatic PCa is distinct from widespread metastases and presents challenges in patient classification. Imaging plays a crucial role in identifying and characterizing oligometastatic lesions, with new techniques such as prostate-specific membrane antigen positron emission tomography demonstrating a remarkable efficacy. The management strategies encompass cytoreductive surgery, radiotherapy targeting the primary tumor, and metastasis-directed therapy for recurrent lesions. Ongoing clinical trials are evaluating the effectiveness of these approaches. Oligometastatic PCa occupies a unique position between locally advanced and high-volume metastatic diseases. While a universally accepted definition and standardized diagnostic criteria are still evolving, emerging imaging technologies and therapeutic strategies hold promise for improving the patient outcomes in this intermediate stage of PCa.