This randomized controlled trial compared radical prostatectomy with observation in 731 men with clinically localized prostate cancer over a median follow-up of 10 years. The study found no significant reduction in all-cause mortality (47.0% vs. 49.9%; HR 0.88; 95% CI, 0.71–1.08; P=0.22) or prostate-cancer-specific mortality (5.8% vs. 8.4%; HR 0.63;