Quality of life outcomes after transnasal endoscopic pituitary surgery using the Glasgow Benefit Inventory

Abstract

Purpose

This study assesses postoperative quality-of-life outcomes via the Glasgow Benefit Inventory (GBI) in patients undergoing transnasal endoscopic pituitary surgery for pituitary adenoma.

Methods

This was a retrospective cohort study in a UK tertiary referral centre. 145 patients who had undergone transnasal endoscopic pituitary surgery for pituitary adenoma over a 6-year period at one institution completed the GBI with at least 3 months’ follow up. Patients with prior radiotherapy were excluded. The GBI is a patient-reported outcome measure that assesses post-intervention outcomes in three domains: ‘general’ functioning, ‘social support’ and ‘physical’ functioning. Pre- and post-operative visual loss scores were additionally assessed via a 1–5 Likert scale. GBI scores were assessed alongside these visual loss scores, clinical and surgical parameters and demographics.

Results

Mean age was 59.5 years (range 20–87 years) and mean follow up was 36 months. A total of 46 of 145 (31.7%) patients had secreting tumours. The most common primary symptom was visual loss. Mean total score for all patients was positive (+8.4); with ‘general’ domain score the most positive (+10.5). All patient groups had overall positive, ‘general’ and ‘social support’ domain scores. Patients with Cushing’s disease reported significantly higher mean total scores (+29.6) than all other groups. Acromegaly (+7.9) and non-functioning adenoma (NFA) groups (+5.2) reported lower mean total scores. ‘Physical’ domain mean scores were negative for acromegaly and NFA groups. There was statistical significance between a pre- to post-operative improvement in visual score and mean total GBI score (p = 0.02) and mean ‘general’ domain GBI score (p = 0.02).

Conclusions

These findings can aid preoperative counselling of patients undergoing this surgery. Those with NFA and no anticipated improvement to visual loss symptoms may be advised of possible worsened physical outcomes and of the option to delay the surgery until symptoms are present.

Keywords:

• Pituitary surgery
• quality of life
• outcomes
• skull base surgery
• Glasgow Benefit Inventory

Ethical approval

This is a retrospective study. The protection of the privacy of research participants has been ensured. Adequate level of confidentiality of the research data has been ensured.

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Frederick Green, Showkat Mirza, Paul Davies and Matthew Sanders. The first draft of the manuscript was written by Frederick Green and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors of this research declare that there are no conflicts of interest associated with this manuscript and there has been no significant financial support for this work that could have influenced its outcome. No competing financial interests exist.

Data availability statement

Data for the study was available electronically to the authors as employees at the institution at which this retrospective study was undertaken. The protection of the privacy of research participants has been ensured. Adequate level of confidentiality of the research data has been ensured.