87 A recent multicentre European study has unveiled promising outcomes for oligometastatic prostate cancer (omPCa) patients undergoing cytoreductive radical prostatectomy (cRP). This pioneering research explores the use of cRP in combination with advanced imaging techniques, such as prostate-specific membrane antigen positron emission tomography (PSMA-PET), to enhance survival rates in this complex cancer subset. The findings were published in the journal European Oncology Urology. The study analysed data from 116 patients treated across 13 European centres between 2014 and 2022. Participants were diagnosed with omPCa using PSMA-PET, which offers greater sensitivity than conventional imaging methods like CT and bone scans. The research aimed to assess the safety, feasibility, and short-term effectiveness of cRP in managing this challenging condition. Patients involved in the study experienced encouraging oncological and functional outcomes. Over a median follow-up of 27 months, only 16% progressed to castration-resistant prostate cancer (CRPC), and the overall survival rate at two years was an impressive 98.9%. Despite these successes, approximately 7% of patients succumbed to their disease, underscoring the aggressive nature of omPCa. Functional results were equally noteworthy. The one-year urinary continence rate reached 82%, reflecting the skill of surgeons and the suitability of cRP in select cases. While 31% of patients experienced complications within 30 days post-surgery, only 5% had severe issues requiring further medical intervention. The study highlights the need for a multimodal approach to omPCa treatment. While cRP proved effective for delaying progression and improving outcomes, its success was bolstered by systemic therapies and metastasis-directed treatments. Notably, the presence of pelvic lymph node involvement negatively impacted prognosis, suggesting its value as a potential predictive factor for tailoring therapies. However, significant variability was observed in treatment approaches across centres, reflecting a lack of standardised protocols for managing omPCa diagnosed via PSMA-PET. Experts believe this underscores the need for more comprehensive clinical guidelines. The findings add to growing evidence supporting the role of cRP in managing advanced prostate cancer. They emphasise the importance of experienced surgical teams and advanced imaging techniques in delivering effective care. Although retrospective in nature, this research lays the groundwork for future studies to refine treatment strategies for omPCa. The research opens new avenues for improving survival rates and enhancing quality of life for patients with limited metastatic disease. With further investigation and standardised practices, the integration of cRP into multimodal treatment plans may offer new hope for those facing this formidable disease.