ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cancer Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1634966
This article is part of the Research TopicRoles of Hormones in Inflammation and Cancer Progression: New Discoveries and Therapeutic StrategiesView all 4 articles
Beyond castration: defining maximal testosterone control in advanced prostate cancer
Provisionally accepted
- 1Department of Reproductive Medicine, The Affiliated Bozhou Hospital of Anhui Medical University, Bozhou, China
- 2Department of Reproductive Medicine, The People's Hospital Bozhou, Bozhou, China
- 3Reproductive male laboratory, The People's Hospital Bozhou, Bozhou, China
- 4Department of Urology, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- 5Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Objective: This study aimed to investigate the correlation between the minimum testosterone (T) level achieved during androgen deprivation therapy (ADT) for advanced prostate cancer and progression and prognosis. And to establish the new recommended threshold for defining castration-level testosterone. Results: Significant differences in TTP were observed among the three groups (P<0.001), and both two groups (P<0.001). The castration low T level group had TTP of 24.62±13.62 months and the lowest percentage of TTP <18 months (33.88%), the castration T level group had TTP of 15.65±9.16 months with the second highest percentage of TTP <18 months (64.34%), the non-castrated T level group had TTP of 10.93±7.89 months with the highest percentage of TTP <18 months (83.33%). There was a significant difference in survival rates between the three groups (P<0.001). Differences were found between the both two groups (P<0.01), with the castration low T level group demonstrating superior 3- and 5-year survival rates compared to the other groups. The non-castrated T level group had the worst prognosis. No significant differences in TTP or survival rates were observed between the castration ultra-low and extreme-low T subgroups. However, surgically castrated patients exhibited the poorest prognosis. Minimum testosterone level was weakly negatively correlated with TTP (r = -0.32, P < 0.001), but not significantly correlated with OS. Conclusion: Challenging the traditional castration standard, this study identifies 10 ng/dL (versus 50 ng/dL) as the critical testosterone threshold for evaluating tumor progression and prognosis in advanced prostate cancer patients on ADT.
Keywords: Testosterone, Castration, advanced prostate cancer, androgen deprivation therapy, testosterone maximal control
Received: 25 May 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Ma, Zhang, Zhang, Zhuo and Xi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jianhong Xi, Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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