Radical treatment of the primary tumour in patients with metastatic prostate cancer (PCa) has been debated for several decades. The concept of combining systemic therapy with primary tumour cytoreduction has been attempted in different malignancies and recent data also suggest a potential benefit of this strategy in PCa. This include an improved local tumour control, but there are also data indicating that local treatment might alter the natural course of metastatic disease. In his presentation, Prof. dr. Brian Chapin (MD Anderson Cancer Centre, Houston TX, United States) discussed the rationale, the available data and ongoing trials regarding local treatment in patients with (oligo) metastatic PCa.