title: [Does antifungal therapy influence postoperative morbidity or long-term survival after surgical resection for pulmonary aspergilloma?].
abstract: BACKGROUND
  Surgical resection of pulmonary aspergilloma is associated with symptoms control, complications prevention, and improved survival, given that the disease is localized and the patient fit enough to undergo surgery. In these operable forms, the impact of perioperative antifungal therapy remains controversial. The purpose of this study was to analyze the impact of antifungal therapy on postoperative morbidity and overall survival in patients with operable pulmonary aspergilloma.
  
  
  METHODS
  The clinical records of 113 patients who underwent thoracic surgery for aspergilloma in our institution from January 1989 to December 2010 were retrospectively reviewed. Of these, 64 patients received antifungal therapy in the perioperative period and were included in group 1, and 49 patients did not receive antifungal therapy and were included in group 2.
  
  
  RESULTS
  Postoperative complication rates were 31.2% in group 1 and 20.4% in group 2 (P = 0.30). Univariable analysis showed that immunocompromised status (P < 0.001), past history of cancer (P = 0.50), preoperative purulent sputum (P = 0.024), and pneumonectomy (P < 0.001) were significantly associated with postoperative complications, but that antifungal therapy was not. Five- and 10-year overall survival rates were respectively 78.3% and 57.8% in group 1 vs. 85.9% and 65.7% in group 2 (P = 0.23). Multivariate analysis revealed that age higher than 50, immunocompromised status and pneumonectomy were significantly associated with adverse long-term survival (χ(2) = 6.59, df = 5, P < 0.001), but that antifungal therapy was not.
  
  
  CONCLUSIONS
  Antifungal therapy has no significant impact on postoperative morbidity or long-term survival following surgical resection of pulmonary aspergilloma. Such procedure is associated with acceptable postoperative morbidity and long-term survival.
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France; Service de chirurgie thoracique et cardiovasculaire, CHU Bocage, université de Bourgogne, 21000 Dijon, France.
authors.forename: P-B
authors.initials: PB
authors.lastname: Pagès
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Grima
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Mordant
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Grand
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Badia
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Le Pimpec-Barthes
authors.affiliation: Service de chirurgie thoracique et cardiovasculaire, CHU Bocage, université de Bourgogne, 21000 Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Bernard
authors.affiliation: Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France. Electronic address: marc.riquet@egp.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Riquet
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications; D055732:Pulmonary Aspergillosis / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D013510:Pulmonary Surgical Procedures; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents
keywords: Antifungal therapy; Aspergilloma; Aspergillome; Lung resection; Morbidity; Morbidité; Prognosis; Pronostic; Résection chirurgicale; Survie; Survival; Traitement antifungique