Long-Term Health-Related Quality of Life of Surgically Treated Pituitary Adenoma Patients: A Descriptive Study

Abstract

Context. The literature concerning the health-related quality of life (HRQoL) of patients with surgically treated PA is controversial. Objective. To describe the long-term HRQoL of surgically treated patients in all PA classes. Design and subjects. The 15D, a generic HRQoL instrument producing a 15-dimensional profile and a single 15D index score (a difference ≥0.03 on a 0-1 scale is considered clinically important), was used to assess the HRQoL of a 13-year surgical cohort of PA patients in Northern Finland. Results and Conclusion. Nighty-eight eligible consecutive patients with surgically treated PA were studied at an average of 6.3 years after their latest pituitary operation. The average postoperative 15D profiles in patients with non-functioning PA and in acromegalics without GH-suppressive medical treatment were similar to those of the age-standardized general population. However, after this rather long followup, the mean 15D score and the number of statistically significant 15D dimension impairments, compared with those of their reference population, were 0.11 and 9/15, 0.10 and 3/15, and 0.08 and 7/15 for Cushing's disease, acromegalics needing somatostatin analog, and prolactinoma patients, respectively. Hypopituitarism with replacement medication was not associated with impaired HRQoL. The somatostatin-analog-associated HRQoL finding warrants further clinical research.

The quality of life in acromegalic patients with biochemical remission by surgery alone is superior to that in those with pharmaceutical therapy without radiotherapy, using the newly developed Japanese version of the AcroQoL

“…It has been reported that patients with pharmaceutical therapy showed decreased QoL scores; however, these studies included a substantial number of patients treated with radiotherapy, which could affect QoL [10,27,37]. In this study, we excluded patients with a history of radiotherapy and showed a decreased QoL in patients with pharmaceutical therapy compared with those with surgery alone, which was in line with the previous report [48].…”

Normal long‐term health‐related quality of life can be achieved in patients with functional pituitary adenomas having surgery as primary treatment

“…The results of the present study demonstrate, as shown previously in patients with acromegaly and in patients with other pituitary adenomas, as well as in other endocrine diseases, that both age and comorbidities are independent predictors of HRQoL. Moreover, the use of the 15D enables indirect comparisons with the previous studies demonstrating impaired HRQoL in Finnish patients with acromegaly and different pituitary adenoma subgroups, as they also used the 15D instrument.…”

“…Several studies suggest patients with functional pituitary adenomas (FPAs) to suffer from health‐related quality of life (HRQoL) impairment . Acromegaly and Cushing's disease associate with the most notable impairment of HRQoL . In 2006, Kauppinen‐Mäkelin et al .…”

“…Using the SF‐36, acromegaly was associated with worse scores for physical functioning, bodily pain and general health perception and Cushing's disease with impairments in physical functioning, bodily pain and anxiety . A study from northern Finland, including a cohort of FPA patients treated with surgery between 1992 and 2004, suggested impaired HRQoL, as assessed by the 15D, in patients with Cushing's disease and prolactinomas in addition to acromegaly patients receiving somatostatin analogue (SSA) treatment . HRQoL impairment has also been reported in prolactinoma patients despite normal prolactin concentrations, and moreover, patients with surgically treated NFPAs have presented with impaired HRQoL .…”

Predictors of quality of life in 102 patients with treated Cushing's disease

“…Data suggesting an association between hypopituitarism and reduced QoL in CD are mixed based upon several generic and disease‐specific QoL questionnaires . Our study did not observe this finding using the HADS and CushingQoL questionnaires.…”