Metastases remain the leading cause of cancer-related mortality. The oligometastasis hypothesis postulates that a spectrum of metastatic spread exists and that some patients with a limited burden of metastases can be cured with ablative therapy. Over the past decade, substantial advances in systemic therapies have resulted in considerable improvements in the outcomes of patients with metastatic cancers, warranting re-examination of the oligometastatic paradigm and the role of local ablative therapies within the context of the improved therapeutic responses, shifting patterns of disease recurrence and possible synergy with systemic treatments. Herein, we reframe the oligometastatic phenotype as a dynamic state for which locally ablative, metastasis-directed therapy improves clinical outcomes, including by prolonging survival and increasing cure rates. Important risk factors defining the metastatic spectrum are highlighted that inform both staging and therapy. Finally, we synthesize the literature on combining local therapies with modern systemic treatments, identifying general themes to optimally integrate ablative therapies in this context.

转移仍然是癌症相关死亡率的主要原因。寡转移假说假设存在一系列转移扩散，并且一些转移负担有限的患者可以通过消融治疗治愈。在过疾病复发和可能与全身治疗的协同作用。在此，我们将寡转移表型重新定义为一种动态状态，局部消融、转移导向治疗可改善临床结果，包括通过延长生存期和提高治愈率。强调了定义转移谱的重要风险因素，这些因素为分期和治疗提供了信息。最后，我们综合了有关将局部疗法与现代全身疗法相结合的文献，确定了在这种情况下最佳整合消融疗法的一般主题。