Case Presentation: Metastasis-Directed Therapy in Oligometastatic Prostate Cancer
Patient Case:
A 64-year-old patient with Gleason 4+3=7 prostate adenocarcinoma underwent radical prostatectomy with negative surgical margins but had a persistently elevated postoperative PSA of 0.75 ng/mL. Despite salvage radiotherapy without androgen deprivation therapy, his PSA continued to rise to 2.29 ng/mL.
Restaging CT of the chest and bone scan demonstrated a solitary sternal metastasis without evidence of additional metastatic disease. He was treated with leuprolide plus abiraterone acetate and prednisone, along with stereotactic body radiotherapy (SBRT) to the sternal lesion.
His PSA became undetectable (<0.02 ng/mL), and after 2 years of systemic therapy, imaging demonstrated no evidence of active disease. Systemic therapy was discontinued, and despite testosterone recovery followed by persistent hypogonadism, his PSA has remained undetectable for 6 years after completing treatment.
