(UroToday.com) The Society of Urologic Oncology (SUO) annual winter meeting included an advanced prostate cancer session and a presentation by Dr. Ale Berlin discussing metastasis-directed therapy for oligorecurrent prostate cancer. Dr. Berlin started with a clinical case example of a 71 year-old-male with a diagnosis of unfavorable intermediate risk prostate cancer who underwent a radical prostatectomy + pelvic lymph node dissection in January 2011. Pathology showed Gleason score 4+3 disease, pT2N0M0 with negative surgical margins. His post-operative PSA was 0.32 ng/mL and he underwent salvage radiotherapy + 6 months of ADT in July 2012. By 2017, his PSA had increased to 1.1 ng/mL, with a PSA doubling time of 11 months. At this point, conventional imaging was negative, however a DCFPyL PET showed oligorecurrent prostate cancer in the left common iliac lymph node: