Organ preservation strategy in laryngeal chondrosarcoma: A single-center experience

 

Background:

Preferred treatment of Laryngeal Chondrosarcoma (LC) consists of laryngeal preservation surgeries (LPS), even if some patients may not avoid total laryngectomy (TL). We investigated risk factors for re-treatment and TL and assessed impact of conservative surgery on oncological and functional parameters.

Methods:

We included 22 patients (7 females, mean age 58 ± 12 years) affected by LC, treated by LPS between 2006 and 2016. Tumor grading and localization, margin status, previous treatment and age were tested as predictors of postoperative recurrence, time to decannulation and organ preservation.

Results:

LPS was applied in 21 out of 22 patients as primary procedure. Eighteen patients were operated only once, while remaining four underwent a total of 13 additional operations. These four patients had all a cricoid localization of tumor. Patients with G2 respect to G1 histology had more frequent re-operations (66,7% vs.11%, p < 0.01) as well as need for TL (66,7% vs. 15,8%, p < 0.05).

Average time to decannulation was 73 ± 47 days in G2 and 20 ± 12 days in G1 patients, respectively (p < 0.05). Final decannulation was achieved in all patients of the non-cricoid group; in the cricoid group, 29% are still cannula-dependent. In three of these 4 patients, TL could not be avoided.

Margin status had no influence on recurrence rate requiring surgery, as distribution of R1 status at first operation was balanced in re-operation and in non-reoperation group (2 out of 4 and 9 out of 18, respectively, p = ns).

Conclusions:

Patients with G2 have more recurrences requiring surgery, longer time to decannulation and higher need for TL. Cricoid localization of tumor was relevant for organ preservation. Margin status signal disease persistence, without influencing need for future surgeries.

Publication History

Publication Date:
23 April 2019 (online)

© 2019. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York