Quality of life in non-functioning pituitary adenoma: A systematic review

Non-Functioning Pituitary Adenomas (pituitary neuroendocrine tumours) (NFPA) have a profound detrimental effect of patient-reported health-related quality of life (QOL). Elucidating the underlying mechanisms by which NFPA influence patients' emotional physical and psychosocial wellbeing would provide the foundation for therapeutic strategies to optimise patient outcomes. A systematic review of the literature was performed in accordance with the PRISMA statement. Studies that utilised validated metrics to report QOL in NFPA were included. Patients with NFPA exhibit worse QOL than healthy controls across both mental and physical domains. Surgery provides significant improvements in QOL within 3 months, and QOL can normalise years after successful treatment. Compared with functioning adenomas, QOL is favourable. The underlying mechanisms for QOL detriment in NFPA is multifactorial and includes visual failure, hypopituitarism, headache, sleep dysfunction, pain, the sick role, treatment-related anxiety, and the morbidity of surgical and radiotherapy treatment. The effects of NFPA on QOL are global, with deficits in physical, psychosocial, and cognitive function. With successful treatment, QOL can return to that of the general population. Targeting hypopituitarism, sleep dysfunction, headache, pain, and disease-related anxiety are paths to improve QOL in NFPA.