gms | German Medical Science

Objective: To evaluate clinical outcome after surgery for pituitary adenomas with special regard to quality of life. To evaluate factors predicting outcome and risks.

Method: Retrospective analysis of a surgical series of 176 patients operated for a pituitary adenoma in a tertiary care center between 2000 and 2009. Clinical data were collected from a chart review and assorted to specific time points: pre-, peri and post-operative, first and last available follow-up. In 2010/2011 these patients were evaluated with the standard SF-36 questionnaire. SF-36 findings were compared within our population and with a German standard population.

Results: Clinical data was collected for all patients (n=176). Overall there were 47,7% male and 52,3% female patients. The mean age was 53 years (SD 15.4, range 18-83). The mean time interval between surgery and this study was 3.8 years. For 109 patients (62%), a complete SF-36 questionnaire could be evaluated. Comparing age within the study group (age: <60 vs. >60) there was no significant difference in physical health. However in mental health, the older patients evaluated their QoL significantly better (p=0.025) than younger patients. Within the study group, male patients evaluated physical health better than female patients (p<0.001), in mental health there was no significant difference. When comparing our population to the German standard population, all patients rated QoL regarding mental health worse (p<0.001). This remained the same after stratifying for gender or age (<60 and >60 years). Concerning physical health, female patients rated QoL worse (p<0.05) whereas male patients were comparable to the standard population. When stratifying for age the rating of physical health was not significantly different from the standard population. Symptoms at time of diagnosis had only limited effect on QoL at time of evaluation. Only patients with Acromegaly at the time of diagnosis evaluated their QoL worse in the dimension of Mental Summary (p<0.003).

Conclusions: In all SF-36 findings, the QoL concerning mental health was evaluated significantly worse. For female patients this was also true for physical health. Age seems to have minor influence but remarkable is the advantage for the older patients in Mental Summary. It appears that after pituitary adenoma surgery, the rehabilitation offered is inadequate for a full recovery of mental health.