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Reply to Alexander Light, Max Peters, Manit Arya, et al's Salvage Focal Therapy vs Radical Prostatectomy for Localized Radiorecurrent Prostate Cancer. JAMA Oncol 2026;12:364-73. https://doi.org/10.1001/jamaoncol.2025.6448.

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Current Surgical Treatment of Prostate Cancer.

Seetharam Bhat Kulthe Ramesh1, Young Hwii Ko2, Hanan Goldberg1

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Robot-assisted radical prostatectomy (RARP) is the gold standard for prostate cancer surgery, offering enhanced visualization and precision. Emerging focal therapies show promise but require further study for long-term effectiveness.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Robot-assisted radical prostatectomy (RARP) is the leading surgical treatment for prostate cancer in the United States.
  • Robotic technology provides significant advantages, including magnified 3D vision and enhanced dexterity for complex procedures.

Purpose of the Study:

  • To review the current landscape of prostate cancer surgical treatments.
  • To highlight the benefits of RARP and the resurgence of focal therapy.

Main Methods:

  • Review of current literature on prostate cancer surgical modalities.
  • Comparison of robot-assisted radical prostatectomy with traditional open surgery.
  • Assessment of advancements in focal therapy for prostate cancer.

Main Results:

  • RARP offers superior visualization and instrument control compared to open prostatectomy.
  • Focal therapy is regaining prominence due to improved imaging and device safety.
  • Long-term outcomes for focal therapy remain under investigation.

Conclusions:

  • RARP is the established gold standard for surgical prostate cancer treatment.
  • Technological advancements continue to enhance surgical therapy performance.
  • Further research is needed to determine the long-term efficacy of focal therapies.