Levesque E, et al. - Researchers used the prospective PROCURE cohort comprising 1766 patients with localized prostate cancer (PCa) undergoing radical prostatectomy (RP), researchers assessed the link between the steroid metabolome with prognostic factors and progression of the disease. Patients were recruited from 2007-2012 and provided blood samples prior to RP. They measured plasma levels of 15 steroids. The median follow-up time after surgery was 73.2 months. Biochemical failure and metastatic disease development were seen in 524 and 75 patients, respectively. Patients with low-risk disease had higher levels of testosterone and androsterone. Risk of cancer progression was reported in association with adrenal precursors. They reported disease-free survival (DFS) with HR of 1.47 and 1.24 in association with a one-unit increment in log-transformed androstenediol (A5diol) and dehydroepiandrosterone-sulfate (DHEA-S) levels, respectively, in high-risk patients. Despite limited number of metastatic events, trends with metastasis-free survival were found for A5diol and DHEA-S levels.