Laryngeal Sarcomas: A Meta-Analysis of Diagnostic and Therapeutic Approaches Based on 84 Patients from Two Leading Centers in Poland

<b>Introduction:</b> Over 98% of all malignant laryngeal cancers are squamous cell carcinomas. Other malignant tumors of the larynx are extremely rare, leading to non-squamous laryngeal cancer patients often receiving improvised treatment. Treatment protocols from other organs are applied, without considering the specific types of surgeries for the larynx. Currently, there is a lack of data on the optimal treatment of primary laryngeal sarcomas.<b>Aim:</b> This study aims to optimize the treatment of laryngeal sarcoma patients, focusing on differences in diagnostic and therapeutic approaches in two oncology centers in Poland.<b>Material and method:</b> A meta-analysis of patient records with laryngeal sarcomas treated between 2000 and 2019 at the Otolaryngology Departments of Jagiellonian University in Kraków and Warsaw Medical University was conducted. Various sarcoma types and diagnostic approaches, including PET, CT, and ultrasound imaging, were analyzed.<b>Results:</b> Over the study period, 84 patients were treated. The most common sarcomas were carcinosarcoma (22), chondrosarcoma (13), and synovial sarcoma (10). Most patients were over 65 years old, and all underwent surgical treatment with appropriate margins. Recurrences occurred in 11% of cases, with 13 patients dying due to distant metastases, primarily in bones.<b>Discussion:</b> The results indicate that while laryngeal sarcoma treatment is less standardized than for squamous cell carcinoma, the two centers applied similar diagnostic protocols. The routine use of PET imaging was identified as a critical improvement for therapeutic decision-making.<b>Conclusions:</b> Partial laryngectomy was found to be effective, with neck lymph node dissection required only for carcinosarcomas. PET imaging is strongly recommended for laryngeal sarcoma diagnostics.