Organ preservation surgery for low- and intermediate-grade laryngeal chondrosarcomas: analysis of 16 cases

Laryngoscope. 2014 Apr;124(4):907-12. doi: 10.1002/lary.24416. Epub 2013 Oct 22.

Abstract

Objectives/hypothesis: To demonstrate that endoscopic resection (ER), open partial laryngectomies, and cricotracheal resection and anastomosis (CTRA) achieve a good balance between oncologic radicality and organ preservation for laryngeal low-grade chondrosarcoma (LCS) and intermediate-grade chondrosarcoma (ICS).

Study design: Retrospective series in an academic institution.

Methods: Between 2001 and 2013, we treated 13 cricoid, two thyroid, and one arytenoid LCS and ICS. Two cricoid and the only arytenoid LCS were managed by ER. Two thyroid ala LCS were submitted to laminectomy. Five ICS and six LCS of the cricoid received CTRA.

Results: Nine patients only required tracheotomy, removed after a maximum of 14 days. Three patients required a nasogastric feeding tube, removed after a maximum of 8 days. Immediate complications included one bleeding, one cervical emphysema, and one partial anastomotic dehiscence. The only late complication was anastomotic stenosis that was resolved by laser resection. All patients regained regular oral feeding and a voice ranging from normal to moderate dysphonia. At the last follow-up, two patients died of unrelated causes, seven are alive with asymptomatic and radiologically stable residual disease, and seven are alive without evidence of persistent disease. One patient received total laryngectomy 11 years after CTRA for recurrent symptomatic disease.

Conclusions: Organ preservation surgery for laryngeal LCS and ICS represents a treatment option with low morbidity, good quality of life, and fair possibility to obtain oncologic radicality.

Level of evidence: 4.

Keywords: Laryngeal chondrosarcoma; cricotracheal resection and anastomosis; endoscopic resection; open neck partial laryngectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arytenoid Cartilage / surgery*
  • Chondrosarcoma / diagnosis
  • Chondrosarcoma / mortality
  • Chondrosarcoma / surgery*
  • Cricoid Cartilage / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Italy / epidemiology
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods*
  • Laryngoscopy
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Neoplasm Staging*
  • Retrospective Studies
  • Survival Rate / trends
  • Tomography, X-Ray Computed
  • Treatment Outcome