Pulmonary aspergilloma: analysis of prognosis in relation to symptoms and treatment.

Abstract

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