Pulmonary aspergilloma: Analysis of prognosis in relation to symptoms and treatment

Lee, Jin Gu; Lee, Chang Young; Park, In Kyu; Kim, Dae Joon; Chang, Joon; Kim, Se Kyu; Chung, Kyung Young

doi:10.1016/j.jtcvs.2009.01.019

« Previous Next »The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 4 , Pages 820-825, October 2009

Pulmonary aspergilloma: Analysis of prognosis in relation to symptoms and treatment

Jin Gu Lee, MD
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea
Chang Young Lee, MD
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea
In Kyu Park, MD
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea
Dae Joon Kim, MD
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea
Joon Chang, MD, PhD
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
Se Kyu Kim, MD, PhD
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
Kyung Young Chung, MD
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea
- Address for reprints: Kyung Young Chung, MD, 250 Seongsanno, Seodaemun-Gu, Seoul, South Korea, 120-752, CPO Box 8044.

Received 7 April 2008; received in revised form 10 December 2008; accepted 24 January 2009. published online 13 April 2009.

Background

This study was conducted to assess the risk of surgical treatment and to evaluate surgical resection in patients with pulmonary aspergilloma.

Method

We reviewed 240 patients with pulmonary aspergilloma who were diagnosed between 1990 and 2006. Of these, 135 patients underwent surgical procedure (group A) and 105 patients were managed with conservative treatment (group B).

Result

Forty complications (29.6%) and 6 operative mortalities (4.4%) developed in group A. During the follow-up period, there were 5 recurrences (3.9%) after surgical procedure. The overall 10-year survival rates of group A and group B were 84.8% and 56.7% (P < .001). In multivariate analysis, age, sex, and surgical treatment were favorable prognostic factors. Symptoms of hemoptysis and blood-tinged sputum were not significant prognostic factor even in univariate analysis.

Conclusion

Our results indicate that (1) early morbidity and mortality rates of surgical treatment for pulmonary aspergilloma are acceptable, and (2) surgical treatment is helpful not only to reduce symptoms but also to prolong the survival of patients with pulmonary aspergilloma. Although more studies are needed, our data support the conclusion that surgical resection should be considered for all patients with pulmonary aspergilloma who have acceptable pulmonary reserve.