Long-term follow-up of cartilaginous tumors of the larynx

BACKGROUND: Cartilaginous tumors of the larynx are uncommon. A literature r eview disclosed approximately 250 cases since 1816; the cricoid cartilage i s the most common site, The rarify of these tumors has made for limited exp erience and, as a consequence, our knowledge is incomplete. OBJECTIVE: To report surgical results as well as long-term follow-up on 6 p atients with cartilaginous tumors of the larynx. DESIGN: A 28-year retrospective study with the patients followed-up from 6 to 28 years (average, 17.8 years). METHODS: Six adult white male patients with cartilaginous tumors of; the la rynx: 4 low-grade chondrosarcoma (1 of the thyroid and 3 of the cricoid) an d 2 chondroma of the cricoid. Surgical treatment included total laryngectom y of the thyroid and 1 of the cricoid chondrosarcoma, and conservation surg ery of the other 4 cricoid tumors: the 2 patients with chondrosarcoma had t otal resection of the cricoid cartilage with thyrotracheal anastomosis, and the 2 patients with chondroma herd local tumor resection using a laryngofi ssure approach. RESULTS:The margins of the specimen were negative for tumor in the 6 patien ts. On follow-up, none of the patients had regional or distant metastasis o r tumor-related death. One of the patients with cricoid chondrosarcoma deve loped recurrence 8 years after conservation surgery, and required a total l aryngectomy for salvage. Survival rate tumor-free at 5 years was 100% and a t 10 years 67%, co-morbidity being responsible for the decrease in survival rate. CONCLUSIONS: Based on this smalt series of patients, the long-term follow-u p of benign and low-grade malignant tumors suggests that the surgical appro ach and prognosis does not depend on histologic distinction and, importantl y underdiagnosed malignancy on tumor sampling and recurrent chondrosarcoma, managed with salvage surgery, have no adverse impact on patient survival. Total resection of the cricoid cartilage with thyrotracheal anastomosis ove r a stent proved an alternative surgical technique in chondrosarcoma who ot herwise would have been treated by total laryngectomy.