Testosterone in prostate cancer: the Bethesda consensus.
BJU Int
; 110(3): 344-52, 2012 Aug.
Article
en En
| MEDLINE
| ID: mdl-22129242
ABSTRACT
OBJECTIVE:
⢠Androgen stimulation of prostate cancer (PCa) cells has been extensively studied. The increasing trend of using serum testosterone as an absolute surrogate for castration state means that the diagnostic measurement of testosterone and the values potentially influencing prognosis must be better understood. This is especially important when PCa progresses from an endocrine to an intracrine status. PATIENTS ANDMETHODS:
⢠We performed a literature review using the MEDLINE database for publications on (i) hormonal changes with androgen deprivation therapy (ADT); (ii) monitoring hormonal therapy with testosterone measurement; (iii) the efficacy of intermittent androgen deprivation (IAD) compared with continuous androgen deprivation; (iv) the underlying mechanisms of castration-resistance; and (v) novel treatments for castration-resistant PCa (CRPCa).RESULTS:
⢠The optimum serum castration levels to be achieved with ADT are still debated. Recently, the 50 ng/dL threshold has been questioned because of reports indicating worse outcomes when levels between 20 and 50 ng/dL were studied. Instead, a 20 ng/dL threshold for serum testosterone after ADT in patients with advanced prostate cancer was recommended.CONCLUSION:
⢠Understanding the mechanisms of androgen biosynthesis relating to PCa as well as prognostic implications might achieve a consensus regarding the role of ADT for both the androgen-sensitive and -insensitive disease state.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Próstata
/
Testosterona
/
Antagonistas de Andrógenos
Tipo de estudio:
Guideline
/
Prognostic_studies
Límite:
Humans
/
Male
Idioma:
En
Revista:
BJU Int
Asunto de la revista:
UROLOGIA
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos