Five-year follow-up of hemoptysis with no malignancy suspected on chest computed tomography: recurrence, lung cancer and mortality

Abstract

Background: Evidence from recent years suggests most cases of hemoptysis to be caused by non-malignant etiologies, but the long-term outcome for these patients has been less thoroughly investigated. Objective: We aimed to assess the rates of hemoptysis recurrence, new lung cancer diagnoses and death within 5 years of initial referral for hemoptysis. Design: In this retrospective study, we reviewed clinical records of consecutive patients referred to evaluation for hemoptysis with no malignancy suspected on chest computed tomography at Aalborg University Hospital, Denmark, in a seven-year period from 2006 to 2012. Results: A total of 609 patients (mean age 56.7 ± 14.1 years, 60.6% male) were included in the study. The etiology was cryptogenic in 81% of patients and no patients had malignant disease. In the following 5 years, lung cancer developed in 1.5% of patients. Median time to diagnosis was 26 (IQR 18–33) months. Nine percent of patients had at least one recurrence of hemoptysis, and the 5-year mortality rate was 12% with median time to death 31 (IQR 13–43) months. Conclusions: Lung cancer developed in less than 2% within 5 years after referral for hemoptysis with no malignancy suspected on chest computed tomography. Further research is needed to identify risk factors for the development of lung cancer in these patients.

Keywords

• hemoptysis
• cryptogenic hemoptysis
• bronchoscopy
• computed tomography of the thorax
• follow-up
• mortality
• recurrence
• prognosis