LARYNGEAL CHONDROSARCOMAS - THE MAYO-CLINIC EXPERIENCE

Background: Laryngeal chondrosarcomas occur infrequently. Their manage ment is often guided by inferences made from the management of sarcoma s arising from more commonly afflicted organs. Method: A retrospective analysis of patients with laryngeal chondrosarcomas treated at the Ma yo Clinic between 1959 and 1992 was performed to assess prognostic fac tors and outcomes after various treatments. Results: A total of 20 pat ients received treatment during this time period. All chondrosarcomas were low grade; 19 involved the cricoid cartilage and one arose in the supraglottic: larynx. Initial treatment consisted of local excision ( often subtotal removal) alone in 12 patients (60%), hemilaryngectomy i n 2 (10%), near total laryngectomy in 2 (10%), and total laryngectomy in 4 (20%). Six patients (30%) had local recurrence: five initially ha d local excision and one had hemilaryngectomy, All local recurrences o r tumor progression developed >3 years after initial treatment, Salvag e surgery was performed in five of the six patients who had local recu rrence, and the other patient was observed. Of the five patients who h ad salvage surgery, three required another resection because of a seco nd recurrence. Conclusions: These results suggest that initial conserv ative subtotal laryngectomy should be explored further because this tr eatment may provide long-term voice preservation in most patients, and patients who experience a recurrence after local excision often have been given several years Of voice preservation. (C) 1997 Wiley-Liss, I nc.