Morgans Alicia K, Hussain Maha
aRobert H. Lurie Comprehensive Cancer Center bNorthwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Curr Opin Urol. 2017 Nov;27(6):547-552. doi: 10.1097/MOU.0000000000000439.
The oligometastatic disease state was initially described over 20 years ago as an 'intermediate' stage in metastatic cancer progression potentially amenable to curative treatment. Interest in identifying men with oligometastatic disease that may be cured has been increasing. However, whether there truly is a distinct oligometastatic state requires prospective validation, and a risk stratification system based on clinical and genomic factors is needed.
We reviewed the existing literature, including 11 ongoing prospective clinical trials, defining the oligometastatic state. We identified specific areas of need including ensuring consensus on the definition of oligometastatic disease and identifying the optimal imaging modality for oligometastatic disease. We identified clinical factors associated with disease aggressiveness in the hormone sensitive metastatic setting, but clinical and molecular risk factors for the oligometastatic setting remain undefined.
Although risk prediction systems for men with oligometastatic prostate cancer are currently lacking, ongoing interest in this disease state and current clinical trials prospectively assessing biologic relevance, optimal imaging, treatment approaches, and predictive markers, including genomic classification, will provide the data necessary to develop a clinically relevant risk stratification system for the oligometastatic disease state.
寡转移疾病状态最初在20多年前被描述为转移性癌症进展中的一个“中间”阶段，可能适合进行根治性治疗。识别可能治愈的寡转移疾病男性患者的兴趣一直在增加。然而，是否真的存在一个独特的寡转移状态需要前瞻性验证，并且需要一个基于临床和基因组因素的风险分层系统。
我们回顾了现有文献，包括11项正在进行的定义寡转移状态的前瞻性临床试验。我们确定了具体的需求领域，包括确保对寡转移疾病定义达成共识以及确定寡转移疾病的最佳成像方式。我们确定了激素敏感转移性环境中与疾病侵袭性相关的临床因素，但寡转移环境的临床和分子风险因素仍未明确。
尽管目前缺乏针对寡转移前列腺癌男性患者的风险预测系统，但对这种疾病状态的持续关注以及当前前瞻性评估生物学相关性、最佳成像、治疗方法和预测标志物（包括基因组分类）的临床试验，将为开发针对寡转移疾病状态的临床相关风险分层系统提供必要的数据。
