Contemporary Surgical Approaches in Managing Laryngeal Chondrosarcoma: A Scoping Review.

Abstract

Objective: The aim of this scoping review is to describe and evaluate current surgical management options for chondrosarcoma of the larynx, and to summarize these techniques with respect to the laryngeal subsite affected.

Data sources: PubMed/MEDLINE and EMBASE databases.

Review methods: The review was conducted according to the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews.

Results: Forty-one articles met eligibility criteria for inclusion in the final analysis, which included a total of 149 unique surgical cases that were analyzed based on affected laryngeal subsites of cricoid, thyroid, arytenoid, and epiglottis. Management of cricoid chondrosarcoma favored transoral endoscopic resection (TER) or transcervical laryngeal preservation surgery (TPLS), which ranged from limited tumor debulking via laryngofissure to larger operations like subtotal to total cricoidectomy with laryngeal reconstruction. Nearly all cases of arytenoid and epiglottic chondrosarcoma were successfully managed with TER techniques. Thyroid chondrosarcoma primarily affected the outer cortex of the cartilage and very rarely involved the endolaryngeal mucosa, making it very amenable to transcervical approaches to remove part of or the entire affected thyroid lamina.

Conclusion: Overall trends in the articles reviewed for this study suggest that more aggressive surgery and R0 resection did not lead to better overall survival, which aligns with the broader philosophical shift in treatment goals to prioritize preservation of the larynx and laryngeal function over complete oncologic resection.

Level of evidence: N/A.