title: Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly.
abstract: OBJECTIVE
  To assess the influence of long-acting somatostatin analogs (SSTA) after initial pituitary surgery on long-term health-related quality of life (HR-QoL) in relation to disease control in patients with acromegaly.
  
  
  METHODS
  This is a cross-sectional study in two tertiary referral centers in The Netherlands.
  
  
  METHODS
  One hundred and eight patients with acromegaly, in whom transsphenoidal (n=101, 94%) or transcranial (n=7, 6%) surgery was performed. Subsequently, 46 (43%) received additional radiotherapy and 41 (38%) were on postoperative treatment with SSTA because of persistent or recurrent disease at the time of study. All subjects filled in standardized questionnaires measuring HR-QoL. Disease control at the time of study was assessed by local IGF1 SDS.
  
  
  RESULTS
  IGF1 SDS were slightly higher in patients treated with SSTA in comparison with patients without use of SSTA (0.85±1.52 vs 0.25±1.21, P=0.026), but the percentage of patients with insufficient control (IGF1 SDS >2) was not different (17 vs 9%, P=0.208). Patients using SSTA reported poorer scores on most subscales of the RAND-36 and the acromegaly QoL and on all subscales of the multidimensional fatigue inventory-20. A subgroup analysis in patients with similar IGF1 levels (SSTA+, n=26, IGF1 SDS 0.44±0.72 vs SSTA-, n=44, IGF1 SDS 0.41±0.65) revealed worse scores on physical functioning, physical fatigue, reduced activity, vitality, and general health perception across all HR-QoL questionnaires in patients treated with SSTA.
  
  
  CONCLUSIONS
  QoL is impaired in association with the need for prolonged postoperative therapy by SSTA in patients with acromegaly despite similar IGF1 levels.
authors.affiliation: Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Postma
authors.forename: Romana T
authors.initials: RT
authors.lastname: Netea-Maier
authors.forename: Gerrit
authors.initials: G
authors.lastname: van den Berg
authors.forename: Jens
authors.initials: J
authors.lastname: Homan
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Sluiter
authors.forename: Margreet A
authors.initials: MA
authors.lastname: Wagenmakers
authors.forename: Alfons C M
authors.initials: AC
authors.lastname: van den Bergh
authors.forename: Bruce H R
authors.initials: BH
authors.lastname: Wolffenbuttel
authors.forename: Ad R M M
authors.initials: AR
authors.lastname: Hermus
authors.forename: André P
authors.initials: AP
authors.lastname: van Beek
mesh_terms: D000172:Acromegaly / Q000188:drug therapy* / Q000523:psychology / Q000601:surgery*; D000236:Adenoma / Q000188:drug therapy / Q000534:rehabilitation / Q000601:surgery; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000188:drug therapy / Q000534:rehabilitation / Q000601:surgery; D006301:Health Services Needs and Demand; D006801:Humans; D060046:Maintenance Chemotherapy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011182:Postoperative Care / Q000379:methods*; D011788:Quality of Life; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D013004:Somatostatin