Background: Systemic treatment is standard for most types of cancer with disseminated metastases. The role of local treatment (LT) of individual tumor foci in patients with oligometastatic disease is unclear and the object of current scientific studies.
Methods: This review is based on pertinent publications retrieved by a selective search in PubMed.
Results: Four randomized trials have shown that radical local treatment confers an advantage with respect to overall survival (OS), compared to systemic treatment alone, in patients with oligometastatic disease. In patients with synchronous metastases and a stable primary tumor, LT prolongs the median overall survival by approximately two years. A single randomized trial for oligometastatic small-cell lung cancer did not show any prolongation of overall survival. Local treatment increased the frequency of grade III side effects by approximately 10%.
Conclusion: Although local treatment already has a place in many guidelines on the basis of the findings of a small number of prospective and retrospective studies, a option of local treatment should be considered by an interdisciplinary tumor board individually for suitable patients.