Kim AH, et al. - Authors assessed the relative efficacy of local vs systemic therapy in patients diagnosed with non-metastatic clinical T4 prostate cancer. Men with clinical T4N0-1M0 prostate cancer from 2004 to 2013 were included via the National Cancer Database. Median 5-year survival for local therapy was 41.5 months while for systemic therapy it was 28.2 months. More patients, among those receiving local therapy, were treated with radiation vs surgery or combined radiation plus surgery with 5-year overall survival by treatment type being 61%, 51.4% and 62.2%, respectively. Findings suggested a correlation between local therapy for clinical T4 prostate cancer and improved overall survival.