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Local therapy
Oligometastatic treatment
A small number of metastases treated with intent, not written off as incurable.
What it is
A patient with one to five metastases is in a different clinical situation from one with widespread disease. Treating each site definitively with surgery, SBRT or ablation, alongside systemic therapy, can produce long disease-free intervals and occasionally cure.
The failure in Indian practice is not technical. It is that patients with three lung nodules are routinely told the disease is metastatic and therefore only palliative, without anyone counting them.
When it is used
- One to five metastases on complete staging
- Colorectal cancer with limited liver disease
- Limited lung or bone metastases
- Long interval between primary treatment and metastasis
How the decision is made
- Whether the disease is genuinely oligometastatic on adequate staging, this needs PET or equivalent, not a chest X-ray.
- Which modality for each lesion, and in what order relative to systemic therapy.
- What happens at the next progression, and whether the option is preserved.
Decided at the board here; each local treatment at the partner unit best suited to that site.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Staging adequacy review before anything is called oligometastatic
- A per-lesion treatment plan across modalities
- Sequencing with systemic therapy
- Surveillance schedule with written triggers
Performed and billed elsewhere
- Surgery, SBRT or ablation
- PET and cross-sectional imaging
- This approach depends entirely on staging being complete. Treating three visible lesions when there are thirty is not oligometastatic therapy.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- Has my staging been complete enough to call this oligometastatic?
- What is the intent, control or cure?
- In what order, and why?
- What is the plan if a new lesion appears?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Colorectal cancer
Colon and rectal cancer, bowel cancer
Lung & thoracic cancer
Non-small cell and small cell lung cancer, mesothelioma, thymic tumours
Prostate cancer
Cancer of the prostate gland
Breast cancer
Including hormone-receptor positive, HER2-positive and triple-negative disease
Kidney cancer
Renal cell carcinoma
Sarcoma & bone tumours
Soft-tissue sarcoma, osteosarcoma, Ewing sarcoma, GIST
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.