Surgical management and oncological outcome of non-squamous cell carcinoma of the larynx: a bicentric study

Andrea Iandelli, Francesco Missale, Andrea Laborai, Marta Filauro, Filippo Marchi, Francesca Del Bon, Pietro Perotti, Giampiero Parrinello, Cesare Piazza, Giorgio Peretti

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Non-squamous cell carcinoma (non-SCC) accounts for about 5% of laryngeal malignancies. Survival data are limited, and consensus on management principles is lacking. The present study reviews our experience in the surgical treatment of non-metastatic non-SCC of the larynx and compares oncological and functional outcomes in a cohort of patients affected by traditional SCC. Methods: We collected data on 592 patients affected by laryngeal neoplasms. Univariate and multivariable survival analyses were performed using Cox proportional-hazards models; survival estimates were reported by hazard ratios (HR) with 95% confidence intervals (CI), and survival curves were established with the Kaplan–Meier method. Results: We identified 326 patients affected by untreated SCC, while 21 had non-SCC histotypes. The non-SCC cohort was composed of 5 soft tissue sarcomas, 8 chondrosarcomas, 2 adenoid cystic carcinomas, 2 neuroendocrine carcinomas, 2 solitary fibrous tumors, 1 Kaposi’s sarcoma, and 1 malignant peripheral nerve sheath tumor. Overall survival and disease-specific survival were not significantly different according to histology (p = 0.6 and p = 0.349, respectively). The non-SCC group showed an increased risk of recurrence (HR 5.87; CI95 2.15–16.06; p < 0.001). Nonetheless, no significant difference (p = 0.31) was found at multivariable analysis between the two groups in total laryngectomy-free survival with an organ preservation rate over 5 years of 81% for the non-SCC histologies. Conclusion: Non-SCC is a broad spectrum pathology, but generalized laryngeal surgical management principles are still feasible and it is possible to identify patients amenable to conservative surgical treatment without affecting survival.

Original languageEnglish
JournalEuropean Archives of Oto-Rhino-Laryngology
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Laryngeal neoplasms
  • Laryngectomy
  • Rare tumors
  • Recurrence
  • Survival

ASJC Scopus subject areas

  • Otorhinolaryngology

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