Disease-specific impairments in quality of life during long-term follow-up of patients with different pituitary adenomas.
OBJECTIVE
Quality of life (QoL) is impaired in patients treated for pituitary adenomas. However, differences in age and gender distributions hamper a proper comparison of QoL. Therefore, we compared age- and gender-specific standard deviations (SD) scores (Z-scores) of QoL parameters in patients treated for pituitary adenomas.


METHODS
We determined Z-scores for health-related questionnaires [the Hospital Anxiety and Depression Scale (HADS), Multidimensional Fatigue Inventory (MFI)-20, Nottingham Health Profile (NHP), and Short Form Health Survey (SF-36)] in patients during long-term follow-up (13 +/- 8 years) after treatment for pituitary adenomas. Z-scores were calculated by comparing the data for 403 patients with acromegaly (n = 118), Cushing's disease (CD; n = 58), prolactinoma (n = 128), and nonfunctioning macroadenoma (n = 99) with a control population (n = 440) for each subscale of the questionnaires and for total QoL score.


RESULTS
All subscales of the questionnaires and the total QoL score were negatively affected in patients compared to controls. Comparing the Z-scores, patients treated for acromegaly reported more impairment in physical ability and functioning and more bodily pain compared to patients treated for nonfunctioning macroadenoma and those treated for prolactinoma. Patients with CD reported impairment in physical functioning compared to patients treated for nonfunctioning macroadenoma. Linear regression analysis, with correction for age and gender, confirmed these findings. Additionally, CD was associated with increased anxiety. Hypopituitarism negatively influenced multiple aspects of QoL.


CONCLUSIONS
QoL is impaired in patients during long-term follow-up after treatment of pituitary adenomas. Patients with pituitary adenomas should be informed of these persistent adverse effects of their disease on QoL to prevent inappropriate expectations with respect to the long-term results of treatment.
van der Klaauw
Agatha A
AA
Leiden University Medical Centre, Department of Endocrinology and Metabolic Diseases, Leiden, the Netherlands. a.a.van_der_Klaauw@lumc.nl
Kars
Marleen
M
Biermasz
Nienke R
NR
Roelfsema
Ferdinand
F
Dekkers
Olaf M
OM
Corssmit
Eleonora P
EP
van Aken
Maarten O
MO
Havekes
Bas
B
Pereira
Alberto M
AM
Pijl
Hanno
H
Smit
Johannes W
JW
Romijn
Johannes A
JA
D000236:Adenoma / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult