Changes in quality of life in patients with acromegaly after surgical remission - A prospective study using SF-36 questionnaire

Patients with acromegaly have a compromised quality of life (QOL). Modem surgical techniques have improved the surgical cure rate. However, there are no prospective studies reporting postoperative changes in QOL among patients cured solely by surgery. The aim of the present study was to determine the effect of surgery on QOL using the 36-item short form health survey (SF-36) questionnaire. SF-36 scores comprise 3 components: the physical component summary (PCS), the mental component summary (MCS) and role-social component summary (RCS). Included in this prospective cohort were 41 patients with acromegaly who underwent surgery alone and achieved postoperative normalization of insulin-like growth factor-1. All participants completed the SF-36 preoperatively and 1 year postoperatively. Preoperatively, RCS and 4 subscale scores (role physical, social functioning, role emotional, mental health) were below the set standards for the normal population. Postoperatively, the PCS and RCS scores did not change significantly, but the MCS score improved significantly (from 48.1 +/- 11.3 to 51.7 +/- 8.9, p=0.03). Further we compared the QOL of 26 patients whose nadir GH level was < 0.4 mu g/L during postoperative oral glucose tolerance testing (complete remission group) with that of 15 patients whose nadir GH level was >= 0.4 mu g/L (partial remission group). There were no significant differences between these groups in terms of PCS, MCS, RCS, or any subscale scores. In conclusion, surgical remission mostly improved the participants' mental condition. There was no difference in QOL between patients who achieved the new remission criteria and those who did not.