In an article published in Eur Urol (2012) by Vickers et al, the authors study a group of 695 men from the Scandinavian prostate cancer group. They randomised the men to watchful waiting or radical prostatectomy. Their model suggests that it is hard to justify surgery in patients with Gleason 6, T1 disease or in those patients much above 70 yr of age. Conversely, surgery seems unequivocally of benefit for patients who have Gleason 8, or Gleason 7, stage T2. For patients with Gleason 6 T2 and Gleason 7 T1, treatment is more of a judgment call, depending on patient preference and other clinical findings, such as the number of positive biopsy cores and comorbidities.