(UroToday.com) The benefit of local therapy to the prostate in metastatic prostate cancer remains unclear. There was no survival benefit to local therapy across unselected patients with metastatic prostate cancer in the HORRAD and STAMPEDE trials, but unplanned subgroup analysis in the HORRAD trial suggested benefit in those with low-volume metastatic disease and planned subgroup analysis in STAMPEDE showed a survival benefit (hazard ratio for death 0.68, p = 0.007).