The clinical implication of oligometastasis suggests that if the primary site (if still present) is controlled, or resected, and the metastatic sites are ablated (surgically or with radiation), there will be a prolonged disease-free interval, and perhaps even cure. Oligometastasis continues to be defined as a state of metastatic disease that is limited in total disease burden, usually by number of clinically evident or radiographic sites (either 1–3 or 1–5), and that is not rapidly spreading to more sites. In this model local control (LC) of oligometastases would have the potential to yield improved systemic control, going against the dogma that control of oligometastatic disease would not have a therapeutic benefit since it represents a clinical manifestation of a few detectable lesions in the setting of widespread occult disease. Although the phenomenon of limited and treatable cancer metastases had been noted historically, Hellman and Weichselbaum proposed the term oligometastases, suggesting that in some patients with a limited number of clinically detectable metastatic tumors, the extent of disease exists in a transitional state between localized and widespread systemic disease. Hellman hypothesized that the process of cancer metastases occurred along a continuum, from locally confined cancer to widely metastatic disease. Hellman first proposed the theory of oligometastases in 1995 as a sequel to the spectrum theory of cancer metastasis. Meanwhile, in the clinic, patients are increasingly being designated as having oligometastatic disease and being treated owing to improved diagnostic imaging, novel treatment options with the potential to provide either direct or bridging therapy, and progressively broad definitions of oligometastasis. Preclinical models are on the outset of laying the groundwork for understanding the oligometastatic state. Contemporary molecular diagnostics are edging closer to being able to determine where an individual metastatic deposit is within the continuum of malignancy. if the primary cancer site (if still present) is controlled, or resected, and the metastatic sites are ablated (surgically or with radiation), a prolonged disease-free interval, and perhaps even cure, may be achieved. The ramification of a diagnosis of oligometastasis is a change in treatment paradigm, i.e. Received: FebruAccepted: FebruPublished: April 13, 2015Ĭlinical reports of limited and treatable cancer metastases, a disease state that exists in a transitional zone between localized and widespread systemic disease, were noted on occasion historically and are now termed oligometastasis. Keywords: metastasis, therapy, tumor, spectrum theory, diaspora 1Departments of Urology and Brady Urological Institute, and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21287, USAĢDepartments of Pharmacology and Molecular Sciences, and Chemical and Biomolecular Engineering, The Johns Hopkins Medical Institutions, Baltimore, MD, 21287, USA
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