Cytoreductive treatment for oligometastatic prostate cancer: Current status and future prospects

Objective To provide an overview of recent advances in cytoreductive treatment strategies for oligometastatic prostate cancer (OMPC), summarize ongoing clinical trials, and review potential biomarkers associated with treatment response and prognosis. Methods Recent evidence on cytoreductive treatment for OMPC was reviewed, with particular emphasis on advances in imaging, surgery, and radiotherapy. Ongoing clinical trials evaluating cytoreductive approaches were summarized. Biomarkers potentially associated with treatment response and prognosis, particularly those reflecting genomic instability and tumor burden, were also reviewed. Results Androgen deprivation therapy, combined with additional systemic treatments such as novel hormonal therapy and chemotherapy, remains the mainstay of treatment for metastatic prostate cancer. Although these systemic therapies provide a survival benefit, they are not curative, and disease progression eventually occurs in most patients. OMPC represents a distinct intermediate stage of metastatic prostate cancer characterized by limited metastatic burden and relatively indolent tumor biology. With advances in imaging, surgery, and radiotherapy, accumulating evidence suggests that cytoreductive treatment may benefit selected patients with OMPC. Emerging biomarkers associated with genomic instability and tumor burden may further improve patient selection. Conclusion Cytoreductive treatment represents a promising therapeutic strategy for selected patients with OMPC. Integration of advanced imaging, local treatment, systemic therapy, and molecular biomarkers may improve patient selection and facilitate precision treatment. Further prospective clinical trials are warranted to establish the optimal role of cytoreductive treatment and validate predictive biomarkers in OMPC.