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Jin Gu Lee
In Kyu Park
Dae Joon Kim
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J Thorac Cardiovasc Surg 2009;138:820-825
© 2009 The American Association for Thoracic Surgery

General Thoracic Surgery

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

Jin Gu Lee, MDa, Chang Young Lee, MDa, In Kyu Park, MDa, Dae Joon Kim, MDa, Joon Chang, MD, PhDb, Se Kyu Kim, MD, PhDb, Kyung Young Chung, MDa,*

a Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea
b Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea

Received for publication April 7, 2008; revisions received December 10, 2008; accepted for publication January 24, 2009.

* Address for reprints: Kyung Young Chung, MD, 250 Seongsanno, Seodaemun-Gu, Seoul, South Korea, 120-752, CPO Box 8044. (Email: kychu{at}yuhs.ac).

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.






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