Chronic obstructive pulmonary disease assessment test for the measurement of deterioration and recovery of health status of patients undergoing lung surgery.

backgroundPatients with early lung cancer often undergo surgery. However, surgery usually results in a decline in health-related quality of life (HRQL). Several questionnaires have previously been used to assess HRQL but some are impractical for clinical use. The chronic obstructive pulmonary disease assessment test (CAT) is simple and has been widely used in respiratory diseases but not for lung cancer. We therefore conducted this study to clarify the role of the CAT in postoperative deterioration and recovery of HRQL.

methodsFifty-five patients who underwent lung resection were recruited into the study. Cardiopulmonary exercise tests and respiratory muscle strength were performed 1 week before surgery (pre-OP) and at post-OP 1 month. HRQL was assessed through the CAT and European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) 1 week pre-OP and post-OP 1 and at 2 months.

resultsFifteen (27.3%) patients underwent wedge resection, four (7.3%) underwent segmentectomy, and 36 (65.5%) underwent lobectomy. After lobectomy, exercise capacity decreased significantly. The deterioration of CAT symptoms (cough, phlegm, chest tightness, dyspnea, activity, confidence, sleep disturbance, and lack of energy) was more prominent in patients who had undergone lobectomy than wedge resection. Based on the EORTC QLQ-C30, physical, role function, fatigue, pain, sleep disturbance, dyspnea, and global health status worsened significantly, whereas there was no significant difference in other symptoms. HRQL recovered at post-OP 2 months in patients who had undergone wedge resection but not lobectomy.

conclusionsPostoperative HRQL and exercise capacity in patients were significantly reduced, especially those who had undergone lobectomy. The CAT significantly reflected postoperative changes in HRQL.