Management of pharyngeal and laryngeal sarcomas

Introduction Sarcomas are among the rarest malignancies (<1%), with 5-15% localised in the head and neck. They are associated with the highest rates of local recurrence and poorest survival. Individualised therapeutic approaches including surgical resection, radiation and chemotherapy are essential. This study aims to demonstrate the interdisciplinary management of pharyngeal and laryngeal sarcomas.

Material and methods  Patients treated for head and neck sarcomas in our hospital over the last 15 years were included in this study, focused on the specifics of pharyngeal and laryngeal sarcomas.

Results 26 cases with sarcomas in the head and neck region were identified, in 10 cases the primarius was located in the pharyngeal and laryngeal region. Pharyngeal cases presented with haemangiopericytomas (n=2), liposarcomas (n=2) and one Ewing sarcoma. They were resected and reconstructed via different approaches (transoral, lateral pharyngotomy, transmandibular). Laryngeally, 3 chondrosarcomas and 2 synovial sarcomas were identified. In 3 cases resection occurred by laryngectomy, in one case the therapy was carried out via hemilaryngectomy and once the recommended laryngopharyngectomy was refused. Adjuvant radiotherapy was given in 5 cases and adjuvant radiation chemotherapy in 3 cases.

Conclusion The surgical procedure is still considered the central treatment concept for sarcomas in the head and neck region. It is based on complete resection and determines the therapeutic success. Modern surgery allows radical resections with the greatest possible preservation of function. Postoperative radiation therapy is advisable in cases of incomplete surgical resection, marginal infiltrations or subtypes with an unfavourable prognosis and a tendency to metastasise.

Publication History

Article published online:
12 May 2023