Background: Oligometastatic bladder cancer (OMBC) is increasingly recognised as an intermediate state between localised and widespread metastatic disease, although its definition and optimal management remain uncertain. Patients with OMBC have a generally more favourable prognosis compared to patients with metastatic disease. However, its definition, diagnostic criteria, and optimal management remain poorly standardised.Methods: This narrative review summarises current evidence on the definitions, diagnostic approaches, and treatment strategies for OMBC, with an emphasis on emerging biological and molecular insights that may refine disease classification and guide therapy.Results: Existing definitions of OMBC rely on lesion count and anatomical distribution, overlooking molecular and clinicopathological heterogeneity that influences prognosis and treatment response. Advances in Positron Emission Tomography (PET)/Computed Tomography (CT) and magnetic resonance imaging (MRI) have improved detection of small-volume disease, while liquid biopsy and circulating tumour DNA show promise for assessing micrometastatic burden. Therapeutic approaches, including metastasis-directed and consolidative therapies, are under investigation. Nonetheless, most data are derived from small, retrospective series, and evidence from prospective studies remains limited.Conclusions: Prospective, biomarker-integrated, and randomised trials are essential to refine definitions, optimise patient selection for therapy, and define the role of precision-based multimodal therapy in OMBC management.
背景：寡转移性膀胱癌（OMBC）作为一种介于局部性与广泛转移性疾病之间的中间状态，正日益受到关注，但其定义及最佳治疗方案仍不明确。相较于转移性疾病患者，OMBC患者通常预后更为良好。然而，其定义、诊断标准及最佳治疗策略仍缺乏统一规范。 方法：本叙述性综述总结了当前关于OMBC的定义、诊断方法及治疗策略的证据，重点关注可能优化疾病分类并指导治疗的新兴生物学与分子学见解。 结果：现有OMBC定义主要依据病灶数量和解剖分布，忽略了影响预后和治疗反应的分子及临床病理异质性。正电子发射断层扫描（PET）/计算机断层扫描（CT）和磁共振成像（MRI）技术的进步提高了小体积病灶的检出率，而液体活检和循环肿瘤DNA在评估微转移负荷方面展现出潜力。包括转移灶定向治疗和巩固治疗在内的多种治疗策略正在研究中。然而，现有数据多来自小型回顾性研究，前瞻性研究证据仍然有限。 结论：开展前瞻性、整合生物标志物的随机临床试验至关重要，这将有助于完善OMBC定义、优化患者治疗选择，并明确基于精准医学的多模式治疗在OMBC管理中的作用。
肿瘤(癌症)患者之家