Skip to main content
Top
Published in: Acta Neurochirurgica 9/2013

01-09-2013 | Clinical Article - Brain Tumors

Health-related quality of life and psychiatric symptoms improve effectively within a short time in patients surgically treated for pituitary tumors—a longitudinal study of 106 patients

Authors: Monika Milian, Juergen Honegger, Christine Gerlach, Tsambika Psaras

Published in: Acta Neurochirurgica | Issue 9/2013

Login to get access

Abstract

Background

Reduced health-related quality of life (HRQoL) is a common complaint in patients suffering from pituitary tumors. Although successful tumor treatment has been reported to lead to an improvement in perceived HRQoL, the temporal gradient at which these improvements occur has not been fully addressed.

Methods

Using three validated health-related questionnaires (SF-36, SCL-90-R, QLS-H), we assessed HRQoL in 106 adult patients harboring pituitary tumors (mean age 48.0 ± 16.0 years) before as well as 3 and 12 months after initiation of treatment. The AcroQoL questionnaire was additionally applied in acromegalic patients.

Results

There was a significant improvement in all but one scale (role-physical) of the SF-36 questionnaire and all but two scales (interpersonal sensitivity, paranoid ideation) of the SCL-90-R, the QLS-H score and the AcroQoL subscales within 3 months after surgical treatment. The trend to amelioration continued at the 12 month re-assessment, but did not reach statistical significance. Linear regression analyses revealed that younger age and male gender favor a more distinct improvement of HRQoL after treatment.

Conclusions

HRQoL is considerably reduced before treatment for pituitary disease. Improvement is an early postoperative phenomenon and occurs within 3 months after treatment. Men and younger patients are more likely to improve within this time span.
Literature
1.
go back to reference Biermasz NR, van Thiel SW, Pereira AM, Hoftijzer HC, van Hemert AM, Smit JW, Romijn JA, Roelfsema F (2004) Decreased quality of life in patients with acromegaly despite long-term cure of growth hormone excess. J Clin Endocrinol Metab 89:5369–5376PubMedCrossRef Biermasz NR, van Thiel SW, Pereira AM, Hoftijzer HC, van Hemert AM, Smit JW, Romijn JA, Roelfsema F (2004) Decreased quality of life in patients with acromegaly despite long-term cure of growth hormone excess. J Clin Endocrinol Metab 89:5369–5376PubMedCrossRef
2.
go back to reference Blum A, Maser E (2003) Enzymology and molecular biology of glucocorticoid metabolism in humans. Prog Nucleic Acid Res Mol Biol 75:173–216PubMedCrossRef Blum A, Maser E (2003) Enzymology and molecular biology of glucocorticoid metabolism in humans. Prog Nucleic Acid Res Mol Biol 75:173–216PubMedCrossRef
3.
go back to reference Bullinger M, Kirchberger I (1998) SF-36. Fragebogen zum Gesundheitszustand. Handanweisung. Hogrefe, Göttingen Bullinger M, Kirchberger I (1998) SF-36. Fragebogen zum Gesundheitszustand. Handanweisung. Hogrefe, Göttingen
4.
go back to reference Burman P, Deijen JB (1998) Quality of life and cognitive function in patients with pituitary insufficiency. Psychother Psychosom 67:154–167, ReviewPubMedCrossRef Burman P, Deijen JB (1998) Quality of life and cognitive function in patients with pituitary insufficiency. Psychother Psychosom 67:154–167, ReviewPubMedCrossRef
5.
go back to reference Comtois R, Beauregard H, Somma M, Serri O, Aris-Jilwan N, Hardy J (1991) The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer 68:860–866PubMedCrossRef Comtois R, Beauregard H, Somma M, Serri O, Aris-Jilwan N, Hardy J (1991) The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer 68:860–866PubMedCrossRef
6.
go back to reference Dekkers OM, van der Klaauw AA, Pereira AM, Biermasz NR, Honkoop PJ, Roelfsema F, Smit JW, Romijn JA (2006) Quality of life is decreased after treatment for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 91:3364–3369PubMedCrossRef Dekkers OM, van der Klaauw AA, Pereira AM, Biermasz NR, Honkoop PJ, Roelfsema F, Smit JW, Romijn JA (2006) Quality of life is decreased after treatment for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 91:3364–3369PubMedCrossRef
7.
go back to reference Dorn LD, Burgess ES, Friedman TC, Dubbert B, Gold PW, Chrousos GP (1997) The longitudinal course of psychopathology in Cushing's syndrome after correction of hypercortisolism. J Clin Endocrinol Metab 82:912–919PubMedCrossRef Dorn LD, Burgess ES, Friedman TC, Dubbert B, Gold PW, Chrousos GP (1997) The longitudinal course of psychopathology in Cushing's syndrome after correction of hypercortisolism. J Clin Endocrinol Metab 82:912–919PubMedCrossRef
8.
go back to reference Ebersold MJ, Quast LM, Laws ER Jr, Scheithauer B, Randall RV (1986) Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas. J Neurosurg 64:713–719PubMedCrossRef Ebersold MJ, Quast LM, Laws ER Jr, Scheithauer B, Randall RV (1986) Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas. J Neurosurg 64:713–719PubMedCrossRef
9.
go back to reference Feldkamp J, Santen R, Harms E, Aulich A, Mödder U, Scherbaum WA (1999) Incidentally discovered pituitary lesions: high frequency of macroadenomas and hormone-secreting adenomas - results of a prospective study. Clin Endocrinol [Oxf] 51:109–113CrossRef Feldkamp J, Santen R, Harms E, Aulich A, Mödder U, Scherbaum WA (1999) Incidentally discovered pituitary lesions: high frequency of macroadenomas and hormone-secreting adenomas - results of a prospective study. Clin Endocrinol [Oxf] 51:109–113CrossRef
10.
go back to reference Flitsch J, Spitzner S, Lüdecke DK (2000) Emotional disorders in patients with different types of pituitary adenomas and factors affecting the diagnostic process. Exp Clin Endocrinol Diabetes 108:480–485PubMedCrossRef Flitsch J, Spitzner S, Lüdecke DK (2000) Emotional disorders in patients with different types of pituitary adenomas and factors affecting the diagnostic process. Exp Clin Endocrinol Diabetes 108:480–485PubMedCrossRef
11.
go back to reference Franke G (1995) Die Symptom-Checkliste von Derogatis - Deutsche Version—[SCL-90-R]. Manual. Beltz Test GmbH, Göttingen Franke G (1995) Die Symptom-Checkliste von Derogatis - Deutsche Version—[SCL-90-R]. Manual. Beltz Test GmbH, Göttingen
12.
go back to reference Furman K, Ezzat S (1998) Psychological features of acromegaly. Psychother Psychosom 67:147–153, ReviewPubMedCrossRef Furman K, Ezzat S (1998) Psychological features of acromegaly. Psychother Psychosom 67:147–153, ReviewPubMedCrossRef
13.
go back to reference Herschbach P, Henrich G, Strasburger CJ, Feldmeier H, Marín F, Attanasio AM, Blum WF (2001) Development and psychometric properties of a disease-specific quality of life questionnaire for adult patients with growth hormone deficiency. Eur J Endocrinol 145:255–265PubMedCrossRef Herschbach P, Henrich G, Strasburger CJ, Feldmeier H, Marín F, Attanasio AM, Blum WF (2001) Development and psychometric properties of a disease-specific quality of life questionnaire for adult patients with growth hormone deficiency. Eur J Endocrinol 145:255–265PubMedCrossRef
14.
go back to reference Johnson MD, Woodburn CJ, Vance ML (2003) Quality of life in patients with a pituitary adenoma. Pituitary 6:81–87PubMedCrossRef Johnson MD, Woodburn CJ, Vance ML (2003) Quality of life in patients with a pituitary adenoma. Pituitary 6:81–87PubMedCrossRef
15.
go back to reference Kauppinen-Mäkelin R, Sane T, Sintonen H, Markkanen H, Välimäki MJ, Löyttyniemi E, Niskanen L, Reunanen A, Stenman UH (2006) Quality of life in treated patients with acromegaly. J Clin Endocrinol Metab 91:3891–3896PubMedCrossRef Kauppinen-Mäkelin R, Sane T, Sintonen H, Markkanen H, Välimäki MJ, Löyttyniemi E, Niskanen L, Reunanen A, Stenman UH (2006) Quality of life in treated patients with acromegaly. J Clin Endocrinol Metab 91:3891–3896PubMedCrossRef
16.
go back to reference Kelly WF, Kelly MJ, Faragher B (1996) A prospective study of psychiatric and psychological aspects of Cushing's syndrome. Clin Endocrinol [Oxf] 45:715–720CrossRef Kelly WF, Kelly MJ, Faragher B (1996) A prospective study of psychiatric and psychological aspects of Cushing's syndrome. Clin Endocrinol [Oxf] 45:715–720CrossRef
17.
go back to reference Korali Z, Wittchen HU, Pfister H, Höfler M, Oefelein W, Stalla GK (2003) Are patients with pituitary adenomas at an increased risk of mental disorders? Acta Psychiatr Scand 107:60–68PubMedCrossRef Korali Z, Wittchen HU, Pfister H, Höfler M, Oefelein W, Stalla GK (2003) Are patients with pituitary adenomas at an increased risk of mental disorders? Acta Psychiatr Scand 107:60–68PubMedCrossRef
18.
go back to reference Lindsay JR, Nansel T, Baid S, Gumowski J, Nieman LK (2006) Long-term impaired quality of life in Cushing's syndrome despite initial improvement after surgical remission. J Clin Endocrinol Metab 91:447–453PubMedCrossRef Lindsay JR, Nansel T, Baid S, Gumowski J, Nieman LK (2006) Long-term impaired quality of life in Cushing's syndrome despite initial improvement after surgical remission. J Clin Endocrinol Metab 91:447–453PubMedCrossRef
19.
go back to reference Marazuela M, Astigarraga B, Vicente A, Estrada J, Cuerda C, García-Uría J, Lucas T (1994) Recovery of visual and endocrine function following transsphenoidal surgery of large nonfunctioning pituitary adenomas. J Endocrinol Investig 17:703–707 Marazuela M, Astigarraga B, Vicente A, Estrada J, Cuerda C, García-Uría J, Lucas T (1994) Recovery of visual and endocrine function following transsphenoidal surgery of large nonfunctioning pituitary adenomas. J Endocrinol Investig 17:703–707
20.
go back to reference McComb DJ, Ryan N, Horvath E, Kovacs K (1983) Subclinical adenomas of the human pituitary. New light on old problems. Arch Pathol Lab Med 107:488–491PubMed McComb DJ, Ryan N, Horvath E, Kovacs K (1983) Subclinical adenomas of the human pituitary. New light on old problems. Arch Pathol Lab Med 107:488–491PubMed
21.
go back to reference Nomikos P, Ladar C, Fahlbusch R, Buchfelder M (2004) Impact of primary surgery on pituitary function in patients with non-functioning pituitary adenomas – a study on 721 patients. Acta Neurochir (Wien) 146:27–35, Erratum in: Acta Neurochir [Wien] 2004, 146:433CrossRef Nomikos P, Ladar C, Fahlbusch R, Buchfelder M (2004) Impact of primary surgery on pituitary function in patients with non-functioning pituitary adenomas – a study on 721 patients. Acta Neurochir (Wien) 146:27–35, Erratum in: Acta Neurochir [Wien] 2004, 146:433CrossRef
22.
23.
go back to reference Pantanetti P, Sonino N, Arnaldi G, Boscaro M (2002) Self image and quality of life in acromegaly. Pituitary 5:17–19, ReviewPubMedCrossRef Pantanetti P, Sonino N, Arnaldi G, Boscaro M (2002) Self image and quality of life in acromegaly. Pituitary 5:17–19, ReviewPubMedCrossRef
24.
go back to reference Rosilio M, Blum WF, Edwards DJ, Shavrikova EP, Valle D, Lamberts SW, Erfurth EM, Webb SM, Ross RJ, Chihara K, Henrich G, Herschbach P, Attanasio AF (2004) Long-term improvement of quality of life during growth hormone [GH] replacement therapy in adults with GH deficiency, as measured by questions on life satisfaction-hypopituitarism [QLS-H]. J Clin Endocrinol Metab 89:1684–1693PubMedCrossRef Rosilio M, Blum WF, Edwards DJ, Shavrikova EP, Valle D, Lamberts SW, Erfurth EM, Webb SM, Ross RJ, Chihara K, Henrich G, Herschbach P, Attanasio AF (2004) Long-term improvement of quality of life during growth hormone [GH] replacement therapy in adults with GH deficiency, as measured by questions on life satisfaction-hypopituitarism [QLS-H]. J Clin Endocrinol Metab 89:1684–1693PubMedCrossRef
25.
go back to reference Rowles SV, Prieto L, Badia X, Shalet SM, Webb SM, Trainer PJ (2005) Quality of life [QOL] in patients with acromegaly is severely impaired: use of a novel measure of QOL: acromegaly quality of life questionnaire. J Clin Endocrinol Metab 90:3337–3341PubMedCrossRef Rowles SV, Prieto L, Badia X, Shalet SM, Webb SM, Trainer PJ (2005) Quality of life [QOL] in patients with acromegaly is severely impaired: use of a novel measure of QOL: acromegaly quality of life questionnaire. J Clin Endocrinol Metab 90:3337–3341PubMedCrossRef
26.
go back to reference Sardella C, Lombardi M, Rossi G, Cosci C, Brogioni S, Scattina I, Webb SM, Gasperi M, Martino E, Bogazzi F (2010) Short- and long-term changes of quality of life in patients with acromegaly: results from a prospective study. J Endocrinol Investig 33:20–25 Sardella C, Lombardi M, Rossi G, Cosci C, Brogioni S, Scattina I, Webb SM, Gasperi M, Martino E, Bogazzi F (2010) Short- and long-term changes of quality of life in patients with acromegaly: results from a prospective study. J Endocrinol Investig 33:20–25
27.
go back to reference van Aken MO, Lamberts SW (2005) Diagnosis and treatment of hypopituitarism: an update. Pituitary 8:183–191, ReviewPubMedCrossRef van Aken MO, Lamberts SW (2005) Diagnosis and treatment of hypopituitarism: an update. Pituitary 8:183–191, ReviewPubMedCrossRef
28.
go back to reference Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short form health survey [SF-36]. Conceptual framework and item selection. Med Care 30:473–474PubMedCrossRef Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short form health survey [SF-36]. Conceptual framework and item selection. Med Care 30:473–474PubMedCrossRef
29.
go back to reference Webb SM, Badia X (2007) Quality of life in growth hormone deficiency and acromegaly. Endocrinol Metab Clin North Am 36:221–232, ReviewPubMedCrossRef Webb SM, Badia X (2007) Quality of life in growth hormone deficiency and acromegaly. Endocrinol Metab Clin North Am 36:221–232, ReviewPubMedCrossRef
30.
go back to reference Webb SM, Badia X, Surinach NL, Spanish AcroQoL Study Group (2006) Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. Eur J Endocrinol 155:269–277PubMedCrossRef Webb SM, Badia X, Surinach NL, Spanish AcroQoL Study Group (2006) Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. Eur J Endocrinol 155:269–277PubMedCrossRef
32.
go back to reference Webb SM, Prieto L, Badia X, Albareda M, Catalá M, Gaztambide S, Lucas T, Páramo C, Picó A, Lucas A, Halperin I, Obiols G, Astorga R (2002) Acromegaly Quality of Life Questionnaire [ACROQOL] a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clin Endocrinol [Oxf] 57:251–258CrossRef Webb SM, Prieto L, Badia X, Albareda M, Catalá M, Gaztambide S, Lucas T, Páramo C, Picó A, Lucas A, Halperin I, Obiols G, Astorga R (2002) Acromegaly Quality of Life Questionnaire [ACROQOL] a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clin Endocrinol [Oxf] 57:251–258CrossRef
33.
go back to reference Wichers-Rother M, Hoven S, Kristof RA, Bliesener N, Stoffel-Wagner B (2004) Non-functioning pituitary adenomas: endocrinological and clinical outcome after transsphenoidal and transcranial surgery. Exp Clin Endocrinol Diabetes 112:323–327PubMedCrossRef Wichers-Rother M, Hoven S, Kristof RA, Bliesener N, Stoffel-Wagner B (2004) Non-functioning pituitary adenomas: endocrinological and clinical outcome after transsphenoidal and transcranial surgery. Exp Clin Endocrinol Diabetes 112:323–327PubMedCrossRef
34.
go back to reference Yanovski JA, Cutler GB Jr (1994) Glucocorticoid action and the clinical features of Cushing's syndrome. Endocrinol Metab Clin N Am 23:487–509, Review Yanovski JA, Cutler GB Jr (1994) Glucocorticoid action and the clinical features of Cushing's syndrome. Endocrinol Metab Clin N Am 23:487–509, Review
Metadata
Title
Health-related quality of life and psychiatric symptoms improve effectively within a short time in patients surgically treated for pituitary tumors—a longitudinal study of 106 patients
Authors
Monika Milian
Juergen Honegger
Christine Gerlach
Tsambika Psaras
Publication date
01-09-2013
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 9/2013
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-013-1809-7

Other articles of this Issue 9/2013

Acta Neurochirurgica 9/2013 Go to the issue

Clinical Article - Neurosurgical Techniques

The long-term outcome of nerve combing for trigeminal neuralgia