Evidence map›Paper›PMID 41662578›Full record

ArticleThe Journal of urology2026

Low Testosterone Levels and Grade Group Progression Among Localized Prostate Cancer Patients on Active Surveillance: A Retrospective Cohort Study.

Tarek Lawen, Rebekka S Garcia, Matthew T Smith, Jeissen Pyo, Noel M Higgason, Margaux J M Robert, Brian F Chapin, Lisly S Chery, John W Davis, John F Ward and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Tarek LawenDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.ORCID 0000-0002-2290-062X
Rebekka S GarciaDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Matthew T SmithDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jeissen PyoMcGovern Medical School, The University of Texas Health Science Center, Houston, Texas.
Noel M HiggasonMcGovern Medical School, The University of Texas Health Science Center, Houston, Texas.
Margaux J M RobertDepartment of Epidemiology, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Brian F ChapinDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Lisly S CheryDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
John W DavisDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
John F WardDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Louis L PistersDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Curtis A PettawayDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Andrew W HahnDepartment of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Daniel E FrigoDepartment of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Peng WeiDepartment of Biostatistics, Division of Discovery Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Carrie R DanielDepartment of Epidemiology, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Justin R GreggDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.ORCID 0000-0002-3852-8199

Funding

Evaluating Dietary Change and a Mediterranean Diet Intervention Among Medically Underserved Men with Prostate CancerK08CA293160 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Justin R Gregg · 2025 to 2026
$420k
NCI NIH HHS K08 CA293160
6 · The paper itself

Abstract

purposeActive surveillance (AS) is an increasingly used strategy for managing localized prostate cancer, yet reliable biomarkers for predicting disease progression remain limited. Low testosterone has been associated with aggressive prostate cancer features at diagnosis, but its role in Grade Group (GG) progression during AS remains unclear. Our objective was to evaluate the association between baseline serum testosterone levels and GG progression in men undergoing AS for localized prostate cancer. MATERIALS AND

methodsWe conducted a retrospective cohort study of 924 men enrolled in an AS program between 2005 and 2024, with a median follow-up of 46.1 months among those who did not progress. Serum testosterone levels were categorized as low if they met a threshold of ≤ 300 ng/dL based on guideline recommendations. Primary outcomes were biopsy progression to GG2 or "extreme" progression to GG3 or higher disease. Multivariable Cox proportional hazards models were used to assess associations between testosterone levels and progression, adjusting for age, PSA density, and biopsy tumor volume. Potential clinically significant confounding by BMI, smoking status, and ethnicity was also considered.

resultsAmong 924 men, the mean age was 63.6 years (SD 8.1), and the mean PSA density was 0.13 ng/mL

conclusionsThese findings suggest that while low testosterone is not clearly associated with moderate progression (GG2), it may increase the risk of higher-grade "extreme" progression to GG3 or higher. Future studies should focus on prospective validation of our findings to elucidate the biological relationship between androgens and prostate cancer progression.

Indexed as

Prostatic NeoplasmsTestosteroneWatchful WaitingAgedBiopsyDisease ProgressionHumansMaleMiddle AgedNeoplasm GradingProstateProstate-Specific AntigenRetrospective StudiesProstate-Specific AntigenTestosteroneactive surveillancehypogonadismprostate cancer

Identifiers

PMID41662578
PMCPMC13580391

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.