(UroToday.com) The Earlier Treatment in Prostate Cancer “How can we maximize the therapeutic index?” educational session at the European Society of Medical Oncology’s (ESMO) 2021 congress included a presentation by Dr. Piet Ost discussing the role of imaging in selecting treatment. Dr. Ost notes that it is important to highlight that the Will Rogers phenomenon is present in prostate cancer. For example, high-risk localized prostate cancer patients that are negative with conventional imaging will have a proportion of patients that will be PET/CT positive and move to the oligometastatic cohort of patients. Thus, this shift will improve outcomes of the localized high-risk patients by removing those that are truly oligometastatic, but also improving outcomes of metastatic patients by adding low-volume oligometastatic patients to this group. As such, these are artificial improvements in outcomes-based novel imaging leading to stage migration.