Oligometastatic Bladder Cancer Management: Current Evidence and Future Directions

Background: Metastatic bladder cancer has long been considered a terminal disease with a poor outcome. Now, evidence suggests that there is an in-between stage called oligometastatic disease, where a patient has only a limited number of metastatic sites. This specific condition challenges the traditional approach of providing only palliative care.
Objective: This review discusses the current methods for diagnosing and managing oligometastatic bladder cancer, emphasizing how crucial advanced imaging techniques like PET-CT are for accurately detecting this state. The main strategy for treatment involves combining multiple types of treatment. This includes using chemotherapy and immune checkpoint inhibitors, along with aggressive, targeted treatments for each specific tumor site. These targeted options, including surgery or stereotactic body radiotherapy, show promise for improving patients' survival. We look at the evidence for these treatments, stress the importance of having a team of different specialists make decisions, and treatment plan.
Methods: We searched PubMed and Google Scholar for bladder cancer, oligometastatic disease, metastasis-directed therapy, metastasectomy, systemic therapy, and immunotherapy. Only the most current or comprehensive study, which covered the years 2004–2025, was considered. The authors also assessed pertinent literature references. Ignored are documents written in languages other than English. Dissertations, oral presentations, and conference abstracts were among the papers that were not considered to be significant scientific research. 
Conclusion: Oligometastatic bladder cancer should be viewed as a distinct clinical entity that presents a unique opportunity for curative-intent therapy. Better research from future clinical trials is urgently needed to confirm the effectiveness of this strategy.