Quality of Life before and after Endoscopic Pituitary Surgery as Measured by the Short-Form-36

Abstract

Objectives/Hypotheses To assess quality of life (QOL) after transnasal, endoscopic pituitary surgery using the 36-item short form (SF-36) instrument. Design Retrospective review was used for this study. Setting The study was conducted in a tertiary academic medical center. Participants Patients who underwent endoscopic, transnasal, transsphenoidal surgery for pituitary adenomas between January 1, 2007 and July 1, 2016 and completed preoperative and postoperative SF-36 surveys. Main Outcome Measures SF-36 survey data as measured by its eight domains (physical functioning, physical role functioning, emotional role functioning, energy/fatigue, emotional well-being, social functioning, pain, and general health). Results There were 18 preoperative, 13 short-term (2 weeks or less after surgery) postoperative, and 14 longer term (>2 weeks after surgery) postoperative surveys. There was no significant difference between preoperative and long-term postoperative SF-36 scores across domains (p > 0.05). In comparing short-term postoperative and preoperative scores, tumor size was positively associated with emotional well-being (p = 0.049) and general health scores (p = 0.031), while visual changes preoperatively were positively associated with general health scores (p = 0.046). Compared with standard U.S. general population summary data, these patients scored lower preoperatively in all domains except for emotional role functioning and pain (p < 0.05). Postoperatively, patients improved to baseline general population data scores with the exception of the physical role functioning domain (p < 0.0001). Conclusion Patients undergoing endoscopic, transnasal, transsphenoidal surgery for pituitary adenomas had lower QOL in six of eight domains preoperatively, but improved to baseline values on the long run after surgery in seven of eight domains. This suggests that minimally invasive pituitary surgery has a restorative role in general QOL as measured by the SF-36.