Regional and distant metastases from laryngeal chondrosarcoma: a systematic review

Objective. Laryngeal chondrosarcomas (LCS) are rare malignancies, constituting approximately 0.5% of all primary laryngeal tumours. These predominantly slow-growing, low-grade tumors can sometimes exhibit a more aggressive clinical course with higher rates of local recurrence and possible regional and/or distant metastases. The true occurrence of metastatic LCS is not well defined in the literature due to limited and scattered data. This systematic review aims to analyse the metastatic behaviour of LCS, focusing on patterns of spread, therapeutic options, and clinical outcomes.
Methods. A systematic review was conducted according to the PRISMA guidelines searching on PubMed, Web of Science, and Scopus databases. Studies included cases of LCS with regional and/or distant metastasis.
Results. A total of 44 articles describing 53 cases of metastatic LCS were included. The mean age of patients was 63.5 years. Aggressive subtypes of LCS (high grade, dedifferentiated, and myxoid variants) accounted for 54.3% of metastatic cases. Distant metastases were observed in 71.7% of patients, with lungs being the most common site. Regional lymph nodes involvement was documented in 37.7% of cases. Surgery was the primary treatment, with total laryngectomy being the most common approach. Radiotherapy was administered as adjuvant treatment in 24.5% of patients. At last follow-up, 49% of patients had died from the disease, and 9.4% had persistent disease.
Conclusions. Although LCS is typically indolent, patients with metastatic disease present significant clinical challenges. The true metastatic rate remains uncertain due to the scattered distribution of data. Aggressive subtypes of LCS exhibit a greater propensity for metastasis, underscoring the need for closer surveillance and individualised treatment strategies.