The Need for Serum Testosterone Measurement with Liquid Chromatography and Tandem Mass Spectrometry in Prostate Cancer Patients Undergoing Castration.

Castration is currently recommended forever in hormone-sensitive metastatic prostate cancer (PCa) and for 3 yr as adjuvant treatment with radiotherapy in localized high-risk and locally advanced PCa [ [1] Mottet M, Cornford P, van den Bergh RCN, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer. Arnhem, The Netherlands: European Association of Urology; 2023. http://uroweb.org/guideline/prostate-cancer/. Google Scholar ]. The measurement of serum testosterone (Ts) to assess castration efficacy and define castration resistance was first recommended during the early 2000s, thanks to the spread of automated chemiluminescent assays (CLIAs) in clinical laboratories [ [2] Oefelein M.G. Feng A. Scolieri M.J. Ricchiutti D. Resnick M.I. Reassessment of the definition of castrate levels of testosterone: implications for clinical decision making. Urology. 2000; 56: 1021-1024 Abstract Full Text Full Text PDF PubMed Scopus (222) Google Scholar ]. However, after some studies reported a lack of correlation between many automated CLIAs and the gold standard of nonautomated mass spectrometry (MS) preceded by liquid or gas chromatography to measure low Ts concentrations, the International Society of Endocrinology stated in 2007 that Ts levels in children and women should be measured with an appropriate method [ [3] Rosner W. Auchus R.J. Azziz R. Sluss P.M. Raff H. Position statement: utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement. J Clin Endocrinol Metab. 2007; 92: 405-413 Crossref PubMed Scopus (982) Google Scholar ].