Functional or radical surgical treatment of laryngeal chondrosarcoma, analysis of survival and prognostic factors: A REFCOR and NetSarc-ResOs multicenter study of 74 cases - Université de Picardie Jules Verne Accéder directement au contenu
Article Dans Une Revue EJSO - European Journal of Surgical Oncology Année : 2024

Functional or radical surgical treatment of laryngeal chondrosarcoma, analysis of survival and prognostic factors: A REFCOR and NetSarc-ResOs multicenter study of 74 cases

Pierre Gazda
  • Fonction : Auteur
Bertrand Baujat
Erwan de Mones del Pujol
Emmanuelle Vaz
Diane Evrard
Yann Lelonge
Esteban Brenet
Sébastien Vergez
Sarah Atallah

Résumé

Introduction Laryngeal chondrosarcoma (LCS) is a rare tumor of slow evolution whose treatment is poorly codified. For a long time, a radical treatment by total laryngectomy (TL) was proposed. More recent studies tend to propose a conservative surgical approach of the larynx. The objective of this study was to compare the overall survival (OS) of total laryngectomized patients (TL+) versus non-laryngectomized patients (TL-). The secondary objectives were to analyse the reoperation free survival (RFS), the total laryngectomy free survival (TLFS) and to identify the preoperative factors leading surgeons to propose TL. Materials and methods A retrospective analysis of prospectively collected incident cases from the REFCOR and NetSarc-ResOs multicenter databases between March 1997 and June 2021 was conducted. A propensity score matching analysis was performed to compare the OS of TL+ and TL-patients. Results 74 patients were included. After propensity score, the 5-year OS of TL+ and TL-patients was comparable (100 %, p = 1). The 5-year RFS rate was 69.2 % (95 % CI [57.5–83.4]) and the 5-year TLFS was 61.7 % (95 % CI [50.4–75.5]). Cricoid involvement greater than 50 % (HR 3.58; IC 95 % [1.61–7.92] p < 0.001), an ASA score of 3 or 4 (HR 5.07; IC 95 % [1.64–15.67] p = 0.009) and involvement of several cartilages (HR 5.26; IC 95 % [1.17–23.6] p = 0.04) are prognostic factors for TL. Dyspnea caused by the tumour is a prognostic factor for reoperation (HR 2.59; IC 95 % [1.04–6.45] p = 0.03). Conclusion These results demonstrate that conservative treatment should be considered as first-line treatment for laryngeal chondrosarcoma.
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Dates et versions

hal-04473760 , version 1 (22-02-2024)

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Pierre Gazda, Bertrand Baujat, Jérôme Sarini, Anne Gomez-Brouchet, Pierre Philouze, et al.. Functional or radical surgical treatment of laryngeal chondrosarcoma, analysis of survival and prognostic factors: A REFCOR and NetSarc-ResOs multicenter study of 74 cases. EJSO - European Journal of Surgical Oncology, 2024, 50 (2), pp.107315. ⟨10.1016/j.ejso.2023.107315⟩. ⟨hal-04473760⟩
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