Oka Ryo, Utsumi Takanobu, Noro Takahide, Suzuki Yuta, Iijima Shota, Sugizaki Yuka, Somoto Takatoshi, Kato Seiji, Endo Takumi, Kamiya Naoto, Suzuki Hiroyoshi
Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi 285-8741, Chiba, Japan.
Cancers (Basel). 2024 Jan 24;16(3):507. doi: 10.3390/cancers16030507.
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.
前列腺癌（PCa）表现出一系列异质性，从惰性形式到高度侵袭性形式，约10%-20%的患者会发生转移性PCa。寡转移性PCa的特征是在特定解剖位置有数量有限的转移病灶，由于先进的成像方式而受到关注。虽然转移性PCa患者通常接受全身治疗，但针对寡转移性PCa的个性化治疗方法正在出现，包括手术和放射治疗干预。这篇综述探讨了寡转移性PCa领域的最新进展，包括其生物学机制、先进的成像技术和相关临床研究。寡转移性PCa与广泛转移不同，在患者分类方面存在挑战。成像在识别和表征寡转移性病灶方面起着关键作用，前列腺特异性膜抗原正电子发射断层扫描等新技术显示出显著疗效。管理策略包括减瘤手术、针对原发肿瘤的放疗以及针对复发病灶的转移导向治疗。正在进行的临床试验正在评估这些方法的有效性。寡转移性PCa在局部晚期和高容量转移性疾病之间占据独特位置。虽然普遍接受的定义和标准化诊断标准仍在不断发展，但新兴的成像技术和治疗策略有望改善PCa这一中间阶段患者的预后。
