Arnaldo Guimarães

Laryngeal chondrosarcoma - Ten years of experience

INTRODUCTION Laryngeal involvement by cartilaginous tumors is rare. However, although accounting for only 1% of laryngeal tumor pathology, they are the most frequently occurring non-epithelial neoplasms. The most probable location is the endolaryngeal surface of the cricoid cartilage. Their symptoms are variable, depending on the size and location, and may include hoarseness, stridor, and dyspnea. Treatment is based on surgical excision. Some centers take into account the degree of differentiation and whether it is a case of relapse when deciding to perform a radical resection. AIM To evaluate this disease in a sample of the Portuguese population. METHODS A review of the medical records from 2002 to 2012 by assessment of clinical processes was performed. Data on demographics, clinical treatments, and outcomes were collected. RESULTS Six patients were included in the study. Five of them underwent total laryngectomy, and in one case, partial excision of the thyroid cartilage was performed. None of the patients had either metastases or tumor-related death. CONCLUSION Laryngeal chondrosarcomas remain a rare disease of unknown etiology, with slow and insidious symptoms. The treatment is surgical, with favorable prognosis, and metastases rarely occur. The main concern regards their propensity to relapse.

Laryngeal Organ Preservation Protocols: Are They Effective?

Objective: Understand the role of organ preservation protocol in locally advanced laryngeal carcinoma according to our experience and determine predictive factors. Method: The study selected all patients treated between 2004 and 2009. During the study period, all patients began treatment with induction chemotherapy (3 cycles of cisplatin and 5-fluoruracil in the majority of cases) followed by radiotherapy and concomitant or subsequent chemotherapy. The results were analyzed by clinical and image evaluation. Results: The study included 40 patients, with mean age of 55 years (range, 38 to 72 years), mainly men. Smoke and alcohol were present in more than 50%, and 70.7% had no comorbidities. Hypopharynx was the most common place (65.8%). At the end of induction chemotherapy 34.2% of patients had an answer >80%. The overall survival is 59% at 3 years. The relapse rate was of 24.7% with an average of time of 8 months (4 to 56 months). No statistical differences were found between different groups of TMN staging system. Conclusion: Different studies have shown that chemotherapy followed by radiotherapy is a valid alternative to surgery in locally advanced operable head and neck cancer, involving the larynx. Our study confirms these results. Local and cervical disease staging did not contribute as a predictive factor for survival or relapse.