What treatment would you recommend for a patient with recurrent oligometastatic abdominal leiomyosarcoma, with two liver lesions?

I would ask for needle ablation.

Leiomyosarcoma is unusual among cancers in that serial oligometastatic recurrence is not uncommon. These people can be managed with serial destructive therapy - resection, needle ablation, or radiosurgery. I have met people with LMS who have had many resections and a...

I agree with the other answer that liver directed local therapy is very reasonable. However, since these patients have a high risk of further metastases, I like to first see if there is a systemic therapy option. Borrowing from other data, if systemic therapy can get good systemic control, the patie...