Laryngeal soft tissue sarcoma: Systematic review and individual patient data analysis of 300 cases

Abstract

Background Laryngeal sarcoma is rare. We performed a systematic review and individual patient analysis to evaluate the patterns of care, prognostic factors, and role of radiotherapy in laryngeal soft tissue sarcoma. Methods A systematic search on PubMed and Google scholar was done. An individual patient data analysis was done. Results Of the 300 cases of laryngeal sarcoma, 80% underwent surgery. 44% underwent larynx preservation surgery and 25% received radiotherapy with surgery. Median progression free survival (PFS) was 48 months and overall survival (OS) of 224 months for the entire cohort. Patients with large primary, cartilage invasion, and positive margins had numerically worse PFS. Cartilage invasion and primary tumor size >3 cm were the most common risk factors for adjuvant radiation therapy. Patients receiving radiotherapy were not associated with better survival. Conclusion Laryngeal sarcoma associated with a good survival. Larynx preservation surgery is feasible in nearly half patients. Adjuvant radiotherapy may be warranted in patients poor prognostic factors.

Spindle cell carcinomaof the larynx: A case report and literature review

“…Whereas laryngeal sarcoma is associated with favorable survival, poor prognosis depends significantly on tumor T-stage and location, which are the two most important factors followed by vocal cord movement, anterior history of head and neck radiation therapy and necrosis. 15 , 16 A systematic review published in 2020, included 300 cases of which 240 patients undergoing surgery (total laryngectomy, preservation surgery), 64 patients receiving 60 Gy (33.5–75 Gy) of adjuvant RT, and 12 receiving exclusive RT. Median progression-free survival (PFS) was 48 months, and 224 months of overall survival (OS) were noted in the entire cohort.…”

“…Authors ended-up suggesting that adjuvant RT may be justified in patients with high-risk factors: tumor size > 3 cm, cartilage invasion, local or distant metastasis. 16 …”

Primary Sarcomas of the Larynx: A Case Series of Four Different Histopathologic Types

“…1,2 Laryngeal sarcomas account for less 1% of laryngeal neoplasms. [1][2][3][4][5] Various sarcoma types have been reported to occur in the larynx. Their nomenclature and classification are similar to their soft tissue counterpart.…”

“…1,2 The vast majority of laryngeal tumor are carcinomas, and squamous cell carcinoma is the most common histologic type. [1][2][3][4][5] Nonepithelial tumors constitute approximately 5% of all laryngeal neoplasms that include sarcoma, lymphoma, and melanoma. 1,2 Laryngeal sarcomas account for less 1% of laryngeal neoplasms.…”

“…Laryngeal neoplasms are divided into epithelial and nonepithelial tumors based on their origin. 1 2 Epithelial tumors comprise the majority of laryngeal neoplasms, and squamous cell carcinoma is the most common malignant neoplasm of the larynx. 1 2 3 Nonepithelial tumors are much less common.…”