par Zlotta, Alexandre ;Debruyne, Frans
Référence European urology. Supplement, 4, 8, page (37-41)
Publication Publié, 2005-11
Article révisé par les pairs
Résumé : There are currently no definitions regarding "Optimal testosterone control in Prostate Cancer". Therefore an Expert Consensus Meeting (May 22 2005, San Antonio, USA) and an expert consultation at a Discussion Forum during the 6th International Consultation on New Developments in Prostate Cancer and Prostate Diseases (June 25 2005, Paris, France), have been organised to discuss definitions regarding "Optimal testosterone control in Prostate Cancer". The experts attending the Expert Consensus Meeting received background information based on recently published data and the predefined definitions and/or recommendations that needed to be discussed. During this meeting, the experts agreed that the term "castration" is misleading in case of luteinising hormone releasing hormone (LHRH) agonists, as castration stands for "surgical removal of the testes", by bilateral orchiectomy. The experts believe that bilateral orchiectomy should be used as a benchmark for introducing the appropriate testosterone level that needs to be achieved with LHRH agonists. As most patients will achieve and maintain a testosterone level of ≤20 ng/dL after bilateral orchiectomy, the experts agreed that this level should be used for defining chemical castration. Furthermore, the experts agreed that a testosterone rise from nadir above 50 ng/dL could be considered as clinically relevant and could have implications on treatment. In order to reflect previous agreements with a larger group of experts in the field, questions regarding "Optimal testosterone control in Prostate Cancer" were asked to the delegates of the Discussion Forum using an interactive voting system. Before the interactive voting session, the currently published data were presented to the audience. Similar to the experts, the delegates also indicated that achieving "the lowest testosterone level possible" is their main goal of hormone therapy. 64% of the delegates agreed that they would consider a castrate level of below or equal to 20 ng/dL to be optimal.