In patients with localized radiorecurrent prostate cancer, salvage focal therapy and salvage radical prostatectomy show similar survival outcomes. Complications were more frequent after radical prostatectomy. The study compared these two salvage strategies in patients who had relapsed after prior radiotherapy. Focal therapy is a newer method that destroys tumors directly in the prostate and is considered less invasive. Radical prostatectomy involves the removal of the entire prostate and is associated with a higher risk of complications such as incontinence or erectile dysfunction. None of these strategies was clearly identified as the best. Multicenter studies confirm the similarity of oncological results. Patients with low-risk cancers may be candidates for focal therapy.