Transoral laser microsurgery for recurrent laryngeal carcinoma after primary treatment: A systematic review and meta-analysis

摘要

Purpose: To evaluate the efficacy and oncologic outcomes of transoral laser microsurgery (TLM) for recurrent laryngeal carcinoma after previous treatment. Materials and Methods: A systematic search in PubMed was performed using mesh word for "laryngeal cancer," crossed with "recurrent," and "TLM." The primary endpoints, including overall survival (OS) rate, local control rate, and disease-specific survival (DSS) were summarized using RevMan software. Adverse events and complications were recorded if reported. Results: The pooled odds ratios (ORs) for main outcomes, including local control, 5-year OS, and DSS were 3.08 (95% confidential indexed [95% CI], 1.88–5.05), 2.29 (95% CI, 1.42–3.67), and 5.05 (95% CI, 2.75–9.27), respectively. The pooled OR for functional outcome, larynx preservation, was 3.82 (95% CI, 2.46–5.94), whereas the pooled risk difference of local recurrence was 45% (95% CI, 26–64%). Conclusions: It seems that TLM is an effective option for recurrent laryngeal cancer with regard to the high incidence of OS, local control, and especially organ preservation. However, more prospective studies are needed to confirm its efficiency.