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Clinical endocrinology · Apr 2016
Health-related quality of life in patients treated for nonfunctioning pituitary adenomas during the years 2000-2010.
- Atte Karppinen, Elina Ritvonen, Risto Roine, Harri Sintonen, Satu Vehkavaara, Leena Kivipelto, Ashley B Grossman, Mika Niemelä, and Camilla Schalin-Jäntti.
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Clin. Endocrinol. (Oxf). 2016 Apr 1; 84 (4): 532-9.
ObjectiveThe published data on health-related quality of life (HRQoL) after treatment of nonfunctioning pituitary adenomas (NFPAs) are conflicting. We evaluated HRQoL in a recent series of patients who had surgery for an NFPA.DesignCross-sectional study including a large control population.Patients And MeasurementsA HRQoL questionnaire (15D) was sent to all patients (n = 161) having undergone transsphenoidal surgery for NFPA in the years 2000-2010 at the Helsinki University Hospital. The 15D score and dimension scores of the study population (n = 137) were compared with those of a large (n = 4967) gender- and age-standardized control population. Possible independent predictors of HRQoL in the patients were estimated with multivariate regression analysis.ResultsPostoperatively, 57% of the patients had normal visual function. After a mean follow-up of 7·4 ± 3·2 years (mean ± SD), 62% suffered from hypopituitarism. Overall, HRQoL was near-normal in patients compared to controls (15D scores 0·885 ± 0·114 vs 0·903 ± 0·093, respectively, P = 0·07). On single dimensions, patients had impaired vision and sexual activity (both P < 0·0005), more depression and distress (both P < 0·005) and less discomfort and symptoms (P < 0·05). Age, body mass index, diabetes, depression and reoperation were independent predictors of impaired HRQoL (all P < 0·05). Thyroxine substitution was associated with impaired and hydrocortisone and testosterone substitution (males only) with better HRQoL (all P < 0·05).ConclusionsThis recent series of NFPA patients demonstrates that overall HRQoL is near-normal after medium term follow-up; the most impaired dimensions were in vision and sexual activity. Comorbidities are strong predictors of impaired HRQoL.© 2015 John Wiley & Sons Ltd.
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