Radiation therapy for early stage (T1-T2) sarcomatoid carcinoma of true vocal cords

Outcomes and patterns of failure

Matthew Ballo, Adam S. Garden, Adel K. El-Naggar, Ann M. Gillenwater, William H. Morrison, Helmuth Goepfert, K. Kian Ang

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Sarcomatoid carcinoma of head and neck mucosal sites is a rare high- grade malignancy that may cause diagnostic and therapeutic controversies. A characteristic of this entity consistently reported but not entirely validated is its relative radioresistance and the general belief is that surgery is the treatment of choice. The objective of this retrospective study was to determine if patients treated with radiation for early glottic sarcomatoid carcinoma had worse outcomes than those achieved with irradiation for the more typical squamous cell carcinoma. Twenty-eight cases of early stage (T1-T2) sarcomatoid carcinoma of the larynx treated with definitive doses of megavoltage irradiation between 1969 and 1995 at The University of Texas M.D. Anderson Cancer Center form the cohort for this analysis. All pathologic material was reviewed to confirm the diagnosis. All tumors manifested spindle cell features with marked cytomorphologic abnormalities characteristic of this entity. Sixteen tumors (57%) had the more typical polypoid gross morphology of sarcomatoid carcinoma. Twenty-one patients (75%) were staged T1 and seven patients (25%) had stage T2 disease. All patients were treated with small laryngeal fields, median size 20 cm2, and to a median dose of 65 Gy. Follow-up ranged from 1.5 to 24 years (median, 10 years). Four patients (14%) had local disease recurrence, and all had salvage total laryngectomies and remained free of local disease. The 5-year actuarial local control rates for patients with T1 and T2 lesions were 94% and 54%, respectively. Only one patient developed regional and distant disease. The 10-year actuarial disease-specific and overall survival rates were 92% and 63%, respectively. Patients with early stage sarcomatoid carcinoma of the glottis treated with radiation had similar control rates to irradiated patients with similar volume disease with the more typical squamous cell carcinoma. The authors contend that the histologic diagnosis of sarcomatoid carcinoma by itself should not influence the decision to treat a patient with early stage glottic disease with irradiation.

Original languageEnglish (US)
Pages (from-to)760-763
Number of pages4
JournalLaryngoscope
Volume108
Issue number5
DOIs
StatePublished - May 1 1998
Externally publishedYes

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Vocal Cords
Radiotherapy
Carcinoma
Tongue Diseases
Squamous Cell Carcinoma
Neoplasms
Radiation
Glottis
Laryngectomy
Larynx
Tongue
Cohort Studies
Neck
Survival Rate
Retrospective Studies
Head
Recurrence

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Ballo, M., Garden, A. S., El-Naggar, A. K., Gillenwater, A. M., Morrison, W. H., Goepfert, H., & Ang, K. K. (1998). Radiation therapy for early stage (T1-T2) sarcomatoid carcinoma of true vocal cords: Outcomes and patterns of failure. Laryngoscope, 108(5), 760-763. https://doi.org/10.1097/00005537-199805000-00024

Radiation therapy for early stage (T1-T2) sarcomatoid carcinoma of true vocal cords : Outcomes and patterns of failure. / Ballo, Matthew; Garden, Adam S.; El-Naggar, Adel K.; Gillenwater, Ann M.; Morrison, William H.; Goepfert, Helmuth; Ang, K. Kian.

In: Laryngoscope, Vol. 108, No. 5, 01.05.1998, p. 760-763.

Research output: Contribution to journalArticle

Ballo, M, Garden, AS, El-Naggar, AK, Gillenwater, AM, Morrison, WH, Goepfert, H & Ang, KK 1998, 'Radiation therapy for early stage (T1-T2) sarcomatoid carcinoma of true vocal cords: Outcomes and patterns of failure', Laryngoscope, vol. 108, no. 5, pp. 760-763. https://doi.org/10.1097/00005537-199805000-00024
Ballo, Matthew ; Garden, Adam S. ; El-Naggar, Adel K. ; Gillenwater, Ann M. ; Morrison, William H. ; Goepfert, Helmuth ; Ang, K. Kian. / Radiation therapy for early stage (T1-T2) sarcomatoid carcinoma of true vocal cords : Outcomes and patterns of failure. In: Laryngoscope. 1998 ; Vol. 108, No. 5. pp. 760-763.
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