Endocrine Abstracts

Introduction: Previously, impaired health-related quality of life (HRQoL) was reported in patients with functional pituitary adenomas (FPA) and/or hypopituitarism. Our aim was to assess HRQoL in a cohort of FPA patients who underwent transsphenoidal surgery as primary treatment at our University Central Hospital between years 2000 and 2010.

Design: A cross-sectional study including an age- and gender-standardized sample of the general population.

Patients and methods: HRQoL was assessed by the 15D questionnaire 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 of 7.4 years (range 2.1–13.0) earlier. To achieve hormonal control, medical therapy, re-operation (n=6) and/or radiotherapy (n=7) were given when appropriate. Replacement therapy was initiated for hypopituitarism (n=43 (43.9%)). The results were compared to those of an age- and gender-standardized sample of the general population (n=6120). Determinants of HRQoL were assessed by Mann–Whitney U test, one-way ANOVA or multiple regression analysis.

Results: Mean total 15D scores were slightly better in patients compared to controls (0.917 vs 0.905, P<0.05). In single dimensions, FPA patients scored better with regards to mental function, and discomfort and symptoms (P<0.05 and P<0.001, respectively). In FPA patients, age at time of survey, number of co-morbidities, hormone and thyroxine replacement therapy predicted impaired HRQoL, but not hydrocortisone replacement, radiotherapy treatment or time after surgery. Only age and comorbidities (P<0.001) and thyroxine replacement therapy (P<0.001) were independent predictors of impaired HRQoL.

Conclusions: Today, it is possible to achieve normal HRQoL in FPA patients. In our University Hospital cohort, this was achieved by transsphenoidal surgery for all and medical therapies and radiotherapy as appropriate. FPA patients demonstrate an age-related decline in HRQoL, similar to that seen in the population in general. Hypopituitarism, especially TSH deficiency associated with impaired HRQoL.