Objective: To assess the influence of use of long-acting somatostatin analogs on long-term health-related quality of life (HR-QoL) in relation to disease control in patients surgically-treated for acromegaly.
Design: Cross-sectional study in two University Medical Centers in The Netherlands.
Patients: One hundred and eight patients (47 m/61 f, mean age 54±11 years) with a minimal follow up period of 1 year after pituitary surgery for GH-producing adenoma as primary treatment. Transsphenoidal surgery was performed in 101 (94%), a craniotomy in 7 (6%) patients. Subsequently, 46 (43%) received additional radiotherapy (RT) and 41 (38%) were on postoperative treatment with somatostatin analogs (SSTA) because of persistent or recurrent disease at the time of study. All subjects filled in standardized questionnaires measuring HR-QoL, depression and fatigue, in addition to the disease-specific AcroQoL. Disease control at time of the study was assessed by local IGF1 Z-scores.
Results: IGF1 Z-scores were slightly higher in patients treated with SSTA in comparison to 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 Z-score >2) was not different (17 vs 9%, P=0.208). Social status, full-time/part-time employment and co-morbidities, as well as scores for anxiety and depression were all comparable between both groups. Patients using SSTA reported poorer scores on most of the subscales of the RAND36 and on all subscales of the Multidimensional Fatigue Inventory-20. In addition, scores on the AcroQoL were worse in patients treated with SSTA. These associations remained in multivariate analysis after correction for confounders like IGF1 Z-scores, RT, and hormone substitution.
Conclusion: Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly.
30 Apr - 04 May 2011
European Society of Endocrinology