AI Article Synopsis
- Laryngeal chondrosarcoma (LC) is a rare cancer that grows slowly, with laryngeal preservation surgery (LPS) being the main treatment; however, some patients may need multiple surgeries or total laryngectomy (TL).
- The study analyzed data from 21 patients to identify risk factors for recurrence and the need for TL, finding that those with higher-grade tumors (G2) experienced more surgery for recurrences compared to lower-grade tumors (G1).
- Results showed that patients with G2 tumors face significant challenges, including higher recurrence rates and a greater likelihood of requiring TL, while factors like tumor localization and margin status influence outcomes without guaranteeing future surgery needs.
Article Abstract
Objectives/hypothesis: Laryngeal chondrosarcoma (LC) is a rare, slowly growing malignancy. The preferred treatment is laryngeal preservation surgery (LPS). Some patients may require multiple interventions or total laryngectomy (TL). We investigated risk factors for retreatment and TL, and assessed the impact of LPS on oncological and functional outcomes.
Study Design: Case series METHODS: We searched our institution database for LC. Tumor grading, localization, and margin status were tested as predictors of recurrence and organ preservation.
Results: We included 21 patients (seven females, mean age 58 ± 12 years). LPS was applied in 20 (95.2%) of them as a primary procedure. Six patients were treated by transoral approach and 14 received "open-neck" LPS. Fifteen (71.4%) were operated only once, while six patients underwent a total of 15 adjunctive procedures. Additional operations were always performed for recurrence of tumors localized within the cricoid plate. The histological grading was G1 in 81% and G2 in 19%. However, two patients with a primary G1 LC showed a G2 recurrence. Reoperations for recurrence were more frequent among patients with G2 in respect to G1 histology (83% vs. 7%, P < .001). Fifty percent of G2 LC and 8% of G1 underwent TL (P < .05). Margin status had no influence on recurrence rate.
Conclusions: Patients with G2 LC have more recurrences requiring surgery and a higher incidence of TL. Cricoid plate localization is relevant for organ preservation. Margin status signals possible disease persistence, without influencing the need for future surgeries. Need for reoperation entails a risk of not being able to maintain organ functionality.
Level Of Evidence: 4 Laryngoscope, 132:838-843, 2022.
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| http://dx.doi.org/10.1002/lary.29826 | DOI Listing |
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