Health-related quality of life in patients treated for nonfunctioning pituitary adenomas during the years 2000-2010.
OBJECTIVE
The 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.


METHODS
Cross-sectional study including a large control population.


METHODS
A 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.


RESULTS
Postoperatively, 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).


CONCLUSIONS
This 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.
Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Atte
A
Karppinen
Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Elina
E
Ritvonen
Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.|Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.
Risto
R
Roine
Department of Public Health, University of Helsinki, Helsinki, Finland.
Harri
H
Sintonen
Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Satu
S
Vehkavaara
Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Leena
L
Kivipelto
Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, UK.
Ashley B
AB
Grossman
Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Mika
M
Niemelä
Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Camilla
C
Schalin-Jäntti
D000236:Adenoma / Q000601:surgery*; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D013507:Endocrine Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D012044:Regression Analysis; D013100:Sphenoid Bone / Q000601:surgery; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000209:etiology