Would you treat the prostate alone, or prostate and mets in an oligometastatic prostate cancer patient?

It's a good question and we are tempted to answer "prostate and mets" as the literature is building up, but we are still waiting for randomized phase III trials. The evidence so far suggests that stereotactic ablative radiotherapy (SABR) is promising. SABR-COMET trial has shown an improved OS for SA...

Enrolling in a clinical trial evaluating this clinical scenario is the best option.

Off-protocol, I would likely offer radiation to the prostate (most likely 55/20 as per STAMPEDE, although a motivated patient who wanted definitive dosing would be not unreasonable) and SBRT the met(s) (a la ORIOLE, S...