Impact of Adrenalectomy on Cortisol-Producing Adenoma: Longitudinal Evaluation of Health-Related Quality of Life following Laparoscopic Adrenalectomy

Urol Int. 2020;104(9-10):789-796. doi: 10.1159/000508765. Epub 2020 Jul 9.

Abstract

Introduction: There is increasing interest in evaluating the quality of life of patients with cortisol-producing adrenocortical adenoma (CPA). Our objective was to assess patient-reported health-related quality of life (HRQOL) in patients with CPA compared to non-CPA.

Methods: Between January 2012 and September 2015, a total of 24 and 62 patients who had laparoscopic adrenalectomy with CPA and non-CPA, respectively, were included in the study. General HRQOL was evaluated on Short Form 8 (SF-8) questionnaire. The SF-8 questionnaire was administered at preoperative baseline and at 3, 6, 9, 12, 18, and 24 months after adrenalectomy. The impact of changing 2 measures of the summary score on the physical component summary (PCS) and mental component summary (MCS) score of SF-8 was evaluated in prospective and longitudinal studies.

Results: The baseline PCS score was significantly lower in the CPA than in the non-CPA group (43.6 vs. 49.0; p = 0.0075). Thereafter, the PCS score was significantly lower in the CPA group at 3, 6, 9, and 12 months postoperatively. The PCS score increased in the CPA group with no significant difference between both groups at 18 months (48.1 vs. 50.2; p = 0.1202) and 24 months (48.0 vs. 50.8; p = 0.3625) postoperatively. However, the baseline MCS score was not significantly different between the CPA and non-CPA group. The MCS score in both groups gradually increased with no significant differences between the groups at any time points after surgery. The PCS score was not significantly improved at all postoperative points than the baseline score in the CPA and non-CPA group. The MCS score was significantly improved than the baseline score from 6 months postoperatively only in the CPA group.

Conclusion: Our research suggests that laparoscopic adrenalectomy may contribute to improving the physical and mental function in HRQOL.

Keywords: Adrenalectomy; Cortisol; Cushing’s syndrome; Health-related quality of life; Longitudinal evaluation.

MeSH terms

  • Adenoma / metabolism*
  • Adenoma / surgery*
  • Adrenal Gland Neoplasms / metabolism*
  • Adrenal Gland Neoplasms / surgery*
  • Adrenalectomy / methods*
  • Adult
  • Aged
  • Female
  • Humans
  • Hydrocortisone / biosynthesis*
  • Laparoscopy*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life*
  • Self Report

Substances

  • Hydrocortisone