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A Duke Radiation Oncology Educational Blog. Friday, July 20, 2012. Radical Prostatectomy versus Observation for Localized Prostate Cancer. The PIVOT trial is published in the NEJM, a randomized comparison of observation vs radical prostatectomy for localized prostate cancer. However, this one is worth looking a little more closely at. Radical Prostatectomy versus Observation for Localized Prostate Cancer.