Obeso Sergio, Llorente José Luis, Díaz-Molina Juan Pablo, Sánchez-Fernández Rafael, Rodrigo Juan Pablo, Suárez Carlos
Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España.
Acta Otorrinolaringol Esp. 2010 Jul-Aug;61(4):262-71. doi: 10.1016/j.otorri.2009.12.002. Epub 2010 Jan 22.
Head and neck chondrosarcomas may adopt different locations and biological behaviour.
We present a retrospective clinical series of 17 chondrosarcomas surgically treated in our Department from 1977 until 2006.
Chondrosarcomas were located in the nasosinusal area (n=6), larynx (n=5), petrous bone (n=3), atlas (n=1), parapharyngeal space (n=1) and trachea (n=1). All patients except for one underwent surgery with radical intention. The mean follow-up period was 84 months (median, 71 months). Six patients developed recurrent disease with a mean latency of 10 months. Two patients died due to the disease and two remained alive with evidence of tumour. Patients with grade I chondrosarcomas presented less recurrent disease than those with grade II or III chondrosarcomas (17% versus 80%, P=0.029). The estimated 5-year survival was 88% with the better survival of patients with grade I chondrosarcomas reaching statistical significance (P=0.023). In 2 patients with cricoid chondrosarcomas, the reconstruction was carried out using the Rethi-Ward technique, and they were without evidence of disease at 71 months (with no cannula) and 145 months (with cannula). Chondrosarcomas of the jugular foramen were treated using a modified infratemporal type A approach.
Low grade head and neck chondrosarcomas have a good prognosis while high grade chondrosarcomas tend to recur, despite radical surgical treatment.
头颈部软骨肉瘤可能有不同的发病部位和生物学行为。
我们回顾性分析了1977年至2006年在我科接受手术治疗的17例软骨肉瘤患者的临床资料。
软骨肉瘤的发病部位包括鼻窦区(n = 6)、喉(n = 5)、岩骨(n = 3)、寰椎(n = 1)、咽旁间隙(n = 1)和气管(n = 1)。除1例患者外,所有患者均接受了根治性手术。平均随访时间为84个月(中位数为71个月)。6例患者出现疾病复发,平均复发潜伏期为10个月。2例患者死于该疾病,2例患者存活且有肿瘤证据。I级软骨肉瘤患者的复发率低于II级或III级软骨肉瘤患者(17%对80%,P = 0.029)。I级软骨肉瘤患者的5年生存率更高,估计5年生存率为88%,差异有统计学意义(P = 0.023)。2例环状软骨软骨肉瘤患者采用雷蒂-沃德技术进行重建,分别在71个月(无插管)和第145个月(有插管)时无疾病证据。颈静脉孔软骨肉瘤采用改良颞下A型入路治疗。
尽管进行了根治性手术,但低级别头颈部软骨肉瘤预后良好,而高级别软骨肉瘤容易复发。