Advanced prostate cancer with bone metastases is generally not a candidate for radical prostatectomy, and this has been the view of both prostate cancer guidelines and expert consensus for many years. A recent retrospective clinical study from the United States found that the 5-year overall survival rate for patients with advanced prostate cancer who underwent prostatectomy was 67.4%, compared to 22.5% for patients with advanced prostate cancer who did not undergo prostatectomy. The results of the clinical study from Germany were very similar to those from the United States, with a 5-year survival rate of 55% for patients with advanced prostate cancer who underwent prostatectomy, compared to 21% for patients with advanced prostate cancer who did not undergo prostatectomy. These changes may have a significant impact on the treatment of prostate cancer in China. This is because currently 60% of prostate cancer patients in China are advanced patients with metastases (the proportion of advanced prostate cancer patients in developed countries in Europe and America is only about 5%), that is, most prostate cancer patients in China have no chance of surgery according to the current view, and the 5-year survival rate is only about 20%. This will be a great progress in the treatment of prostate cancer in China. Professor Shen Zhoujun’s team at Huashan Hospital of Fudan University was one of the first teams in China to perform da Vinci robotic-assisted laparoscopic surgery for high-risk prostate cancer. The main advantages of da Vinci robot-assisted prostate cancer surgery are clearer three-dimensional vision and finer hand movements, which are more obvious in relatively narrow male pelvic organ surgery. Prof. Shen’s team has done a lot of clinical research on surgery for oligometastatic prostate cancer. We hope to provide new treatment modalities for patients with advanced prostate cancer with bone metastases in the near future, so that most advanced patients can achieve better long-term survival. At present, surgical treatment is mostly for patients with oligometastatic prostate cancer. Oligometastasis is defined in terms of the number of tumor metastases. The concept of oligometastasis was first introduced by researchers when the number of metastases was less than or equal to five. In prostate cancer with bone metastases, the number of bone metastases is less than or equal to 3, which is the basis for the selection of cases for treatment of the primary site. The main goal of surgery for oligometastatic prostate cancer is to prolong survival and improve local symptoms. Which patients with oligometastatic prostate cancer will benefit from reduced radical surgery of the primary site? This is an important question to consider in clinical exploration. Our experience is generally based on a combination of the following factors: (1) low metastatic load (≤5 bone metastases, preferably ≤3, normal alkaline phosphatase, no bone pain, no visceral metastases); (2) sensitivity to endocrine therapy; (3) history of prostate obstruction with difficulty in urination; (4) young age, good physical status, no significant co-morbidity, no rectal invasion, no invasion of the urethral sphincter, ability to tolerate surgery and anesthesia; (5) patient’s subjective willingness to cooperate with the treatment. Finally, it should be noted that the current guidelines recommend that the standard of care for metastatic prostate cancer remains endocrine therapy, chemotherapy, molecular targeting, and immunotherapy for the primary prostate cancer. Although reduction surgery for metastatic prostate cancer at the primary site has been a hot topic in the past year or two, it is still a clinical exploration beyond the standard treatment options recommended by current guidelines. A comprehensive and individualized treatment philosophy should be emphasized throughout the treatment. The ultimate goal is to maximize patient benefit and to avoid overtreatment and adverse effects of treatment.