The biology of prostate cancer metastases: does oligo differ from polymetastatic?

Purpose of review To examine the studies of prostate cancer biology, which evaluated oligometastatic and polymetastatic disease to identify data supporting differences between them. Recent findings Studies of tumor biology suggest that malignant cells of limited metastatic potential exist, which may explain the phenomenon of oligometastatic disease. Conversely, oligometastatic disease may represent earlier presentation of polymetastatic disease in a proportion of cases. Data suggest molecular differences between oligo and polymetastatic disease, although larger studies are required to validate these results. Micro RNA differences between oligo and polymetastatic disease appear especially intriguing, which may regulate gene expression and modulate metastatic potential. Summary Although metastatic prostate cancer is traditionally treated by systemic therapy alone, the concept of oligometastatic disease prompting ablative therapy of metastases is emerging. Better understanding of the molecular alterations driving oligometastatic disease may help tailor therapy for these patients, by helping discriminate between true oligometastatic disease and disease destined to progress to polymetastatic status.