(UroToday.com) The Society of Urologic Oncology (SUO) annual winter meeting included an advanced prostate cancer session and a presentation by Dr. Brian Chapin discussing the role of surgery and radiation in metastatic prostate cancer. Dr. Chapin emphasized that the rationale for definitive treatment of the primary tumor in metastatic prostate cancer has several bases. This includes (i) retrospective data suggesting an improvement in overall survival, (ii) reduction of local symptomatic progression, (iii) persistence of molecularly “lethal prostate cancer” in the primary tumor, (iv) alteration of tumor biology by systemic therapy, and (v) feasibility and safety of a randomized trial for local therapy.