Don't know what your pathology is but this seems like it would have to be managed and treated as locally advanced/regional. The scan showed one area with extraprostatic uptake. Since the imaging has finite resolution/sensitivity, you have to assume there is microscopic extraprostatic disease in the pelvis. I assume that will lead to radiotherapy of the pelvic region and a booster dose to the location that lit up, in addition to removing or radiating the prostate + a course of intensified hormone therapy. Long term disease control under those parameters is excellent -- better with intermediate risk, not quite as good with high/very high risk.