The notion that oligometastatic disease is unique from early stage and widely metastatic disease is gaining traction amongst several solid tumor types, including prostate cancer. Optimizing use of treatment modalities to avoid excess toxicity while increasing patient benefit has been at the center of new clinical trials. The possibilities for study design are numerous, and resources are limited. Thus, studies such as that reported by Deek et al. provide the foundation on which to design larger and potentially practice-changing studies. Several large, phase III trials designed to evaluate this approach in prostate cancer are needed before such approaches become standard. —Mark A. Klein, MD