The Scandinavian Prostate Cancer Group has published the results from the extended follow up of the SPCG-4 study, which compared watchful waiting with radical prostatectomy in men with early-stage prostate cancer. Extended follow-up 23 years after the initiation of the study has confirmed a substantial reduction in mortality after radical prostatectomy: 247 of the 348 men in the watchful-waiting group died, compared with 200 of 347 men in the surgery group.