(UroToday.com) The STAMPEDE trial recently demonstrated a survival benefit for selected patients with metastatic prostate cancer who were treated with androgen deprivation therapy plus prostate radiotherapy.1 This trial demonstrated that the treatment of the primary tumor improved as well as failure-free survival in patients with M1a prostate cancer. Furthermore, radiotherapy was associated with a survival benefit in individuals with M1b disease with a low metastatic burden. However, little is known regarding the efficacy of surgery in the same setting, as patients treated with radical prostatectomy have not been studied.