More than 230,000 men will be diagnosed with prostate cancer this year in the United States, but determining their course of treatment remains a source of considerable debate. A new study by researchers from Uppsala University Hospital, Sweden, Harvard School of Public Health, and colleagues – which draws from one of the few randomized trials conducted to directly address this issue – finds a substantial long-term reduction in mortality for men with localized cancer who undergo a radical prostatectomy. While the benefit on mortality appears to be limited to men less than age 65, surgery did reduce the risk of metastases and need for additional treatment in older men. The article appears in the New England Journal of Medicine.