[Improvements of ablative local treatments modify the management of the oligometastatic disease]

Abstract

Systemic treatments rarely allow durable disease control at a metastatic stage. However, distinct metastatic profiles should be considered: from an oligometastatic state (one to five metastases) to disseminated metastases. Biomolecular mechanisms of metastatic spread and patterns of presentation and care were studied. A review of the literature focusing on local ablative treatments of oligometastases was performed. Improvement of local treatments, including surgical ablation, radiofrequency and irradiation (mostly with stereotactic radiotherapy) allow for metastatic control rates at treated sites of over 70% and increased survival with preserved quality of life. Improvements of ablative local treatments have dramatically modified the management of the oligometastatic disease. Metastatic disease may become in rare occasions a chronic disease, with some patients experiencing prolonged remission or even cure, provided proper selection of patients for local aggressive treatments using optimal criteria and scores that remains to be defined.