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In OMPC, phase II randomized trials show that consolidating all imaging\u2010visible lesions\u2014most commonly with stereotactic body radiotherapy (SBRT)\u2014prolongs progression\u2010free survival, delays systemic therapy escalation, and extends both androgen deprivation therapy\u2010free and eugonadal progression\u2010free survival. This is achieved with low severe toxicity rates with organ\u2010at\u2010risk dose constraints. Elective nodal radiotherapy enhances regional control of pelvic nodal recurrence, and MDT can be layered onto modern systemic backbones in the metachronous oligometastatic, synchronous oligometastatic and oligoprogressive settings, provided that complete lesion ablation is feasible. Prostate\u2010specific membrane antigen (PSMA) PET\/CT is pivotal for staging and restaging, while whole\u2010body diffusion\u2010weighted MRI serves as a complementary tool for assessing disease activity, particularly in treated bone metastases. In OMBC, MDT is most appropriately considered a consolidation strategy for patients with near\u2010complete response and few technically amenable residual lesions, or to control oligoprogression, allowing an otherwise effective systemic regimen to be maintained. While prospective and retrospective data support high local control rates, robust, disease\u2010specific randomized evidence of survival benefit remains limited. In both diseases, successful outcomes hinge on harmonized definitions, explicit lesion enumeration, adherence to dose\u2010volume constraints for ablative techniques, and patient\u2010centered endpoints. Future priorities include developing biologically informed patient selection criteria, standardizing imaging and reporting protocols, and conducting randomized trials to quantify the incremental benefit of MDT beyond contemporary systemic therapy.<\/jats:p>","DOI":"10.1111\/iju.70324","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T10:24:38Z","timestamp":1766571878000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oligometastatic Prostate and Bladder Cancer: An Integrative Narrative Review"],"prefix":"10.1111","volume":"33","author":[{"given":"Wei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology Institute of Science Tokyo  Tokyo Japan"},{"name":"Department of Urology Zigong Fourth People's Hospital  Zigong Sichuan 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