title: Measurement of serum testosterone during androgenic suppression in patients with prostate cancer: A systematic review.
abstract: BACKGROUND
  Clinical practice guidelines recommend measuring serum testosterone (ST) during androgenic suppression (AS) to assess its efficacy and define castration resistance (CR). The objectives of this systematic review were to assess the level of scientific evidence that justify checking ST levels during AS, when to perform it and for what purpose.
  
  
  METHODS
  We performed a search in PubMed with the following mesh terms: androgen suppression, testosterone, and prostate cancer. The search was narrowed to original articles published in English.
  
  
  RESULTS
  We found 8 publications that analysed the clinical impact of ST concentrations during AS. In all of the series, ST was measured using chemiluminescent assays. However, only indirect methods based on liquid or gas chromatography for its extraction and subsequent quantification using mass spectrometry are recommended, especially for measuring low levels. The endpoints were specific survival and CR-free survival. Six studies were retrospective. The series were not uniform in terms of clinical stage, types of AS and ST assessment methods. In general, low ST levels (<20ng/dL or <32ng/dL) were related to longer CR-free survival. The measurements were performed every 3 or 6 months. Four studies confirmed the beneficial effect of adding bicalutamide when detecting microelevations above 50ng/dL.
  
  
  CONCLUSIONS
  The level of scientific evidence justifying the measurement of ST during AS is low, and the methods employed for quantifying ST levels are inadequate. However, we consider it useful to check ST levels during AS, and there appears to be an association between low ST levels and better disease outcomes. In the event of microelevations above 50ng/dL, we recommend the administration of bicalutamide.
authors.affiliation: Servicio de Urología, Hospital Vall d́Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Morote
authors.affiliation: Servicio de Urología, Hospital Vall d́Hebron, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: lucasregis@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Regis
authors.affiliation: Servicio de Urología, Hospital Vall d́Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Celma
authors.affiliation: Servicio de Urología, Hospital Vall d́Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Planas
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use; D000813:Anilides / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D005485:Flutamide / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D009570:Nitriles / Q000627:therapeutic use; D009842:Oligopeptides / Q000627:therapeutic use; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000628:therapy*; D013739:Testosterone / Q000097:blood*; D014105:Tosyl Compounds / Q000627:therapeutic use
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D009842:Oligopeptides; D014105:Tosyl Compounds; C431566:acetyl-2-naphthylalanyl-3-chlorophenylalanyl-1-oxohexadecyl-seryl-4-aminophenylalanyl(hydroorotyl)-4-aminophenylalanyl(carbamoyl)-leucyl-ILys-prolyl-alaninamide; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D005485:Flutamide; C053541:bicalutamide
keywords: Androgenic suppression; Cáncer de próstata; Prostate cancer; Supresión androgénica; Testosterona; Testosterone