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

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. Laryngoscope, 124:907-912, 2014