In this issue of European Urology, De Bruijn et al [1] report on safety outcomes with a focus on adverse events (AEs) caused by surgery or systemic therapy in the SURTIME trial [2]. The European Organisation for Research and Treatment of Cancer 30073 SURTIME trial was an open-label, multicentre, randomised controlled study conducted at 19 centres in the Netherlands, Belgium, UK, and Canada. Eligible patients had histologically confirmed, previously untreated, metastatic renal cell carcinoma (mRCC) of the clear cell subtype with a resectable asymptomatic primary tumour in situ and required systemic therapy with sunitinib.