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

• Published in: Clinical endocrinology (Oxford) Vol. 82; no. 3; pp. 412 - 421
• Main Authors: Ritvonen, Elina, Karppinen, Atte, Sintonen, Harri, Vehkavaara, Satu, Kivipelto, Leena, Roine, Risto P., Niemelä, Mika, Schalin-Jäntti, Camilla
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.03.2015; Wiley Subscription Services, Inc
• Subjects: Acromegaly - physiopathology; Acromegaly - surgery; Adult; Aged; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Pituitary ACTH Hypersecretion - physiopathology; Pituitary ACTH Hypersecretion - surgery; Pituitary Neoplasms - physiopathology; Pituitary Neoplasms - surgery; Prolactinoma - physiopathology; Prolactinoma - surgery; Quality of Life; Surveys and Questionnaires
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/cen.12550

Summary Background Previous studies report impaired health‐related quality of life (HRQoL) in patients with functional pituitary adenomas (FPA). We assessed HRQoL in FPA patients having undergone surgery at our University Central Hospital between 2000 and 2010, with combined adjuvant treatment given to achieve strict hormonal control. Design A cross‐sectional study including a large control population. Patients and methods HRQoL was assessed by the 15D in 100 FPA patients (acromegaly n = 47, Cushing's disease n = 21, prolactinoma n = 26, TSH‐adenoma n = 2, gonadotropinoma n = 4), operated on a mean 7·4 (range 2·1–13·0) years earlier. An age‐ and gender‐standardized sample of the general population (n = 4924) served as controls. HRQoL determinants were assessed by independent samples t‐test and multiple regression analysis. Results Hormonal remission rate was 90·9% and 43·9% of the patients received replacement therapy. The mean 15D scores were similar in patients and controls (0·917 vs 0·922, P = 0·568). On single dimensions, patients were worse off regarding speech and sexual activity (both P < 0·05) and better off regarding discomfort and symptoms (P < 0·05). Age (P = 0·001), co‐morbidities (P = 0·009), Cushing's disease (P = 0·034), and thyroxine dose (P = 0·002) predicted impaired HRQoL, but not hypopituitarism, hydrocortisone replacement, radiotherapy, or time after surgery. Conclusions It is possible to achieve near‐normal HRQoL in surgically treated FPA patients given adjuvant treatment to achieve strict hormonal remission. However, in addition to age and co‐morbidities, Cushing's disease and need for thyroxine replacement therapy predict impaired HRQoL.