Prostate cancer
Oligometastatic PCa: treating the primary and/or metastases

Salvatore (74 years old)

Salvatore, aged 74 years and spending his days with ‘fix-it’ projects for family members and neighbours, was treated with RP for T2N0M0 PCa 5 years ago. He received early prostate bed salvage RT without ADT for biochemical recurrence 2 years ago at a PSA level of 0.22 ng/ml. Follow-up information today:

  • Asymptomatic
  • No relevant comorbidities
  • Otherwise fit
  • PSA: 0.7 ng/ml
  • PSA-DT: 8 months
  • PSMA-PET/CT: uptake in right acetabular and L1 spinous process

Which of the following options would you choose for this patient?