Oncologic outcomes of transoral laser microsurgery for radiorecurrent laryngeal carcinoma: A systematic review and meta-analysis of English-language literature

Authors

  • Yujay Ramakrishnan MRCS, Ed, DOHNS, MFPM,

    1. Department of Otolaryngology- Head and Neck Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
    2. Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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  • Mike Drinnan BEng, MEng, PhD,

    1. Department of Medical Physics, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
    2. Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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  • Foon Ng Kee Kwong MBBS,

    1. Department of Otolaryngology- Head and Neck Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
    2. Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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  • David G. Grant MD,

    1. Department of Medical Physics, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
    2. Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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  • Hisham Mehanna PhD, BMedSc (Hons), MBChB (Hons), FRCS, FRCS (ORL-HNS),

    1. Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
    2. School of Cancer Sciences and Institute of Head and Neck Studies and Education, University of Birmingham, Birmingham, United Kingdom
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  • Terry Jones BSc(Hons), FRCS(ORL-HNS), MD,

    1. Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
    2. Liverpool CR-UK Centre, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, United Kingdom
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  • Vinidh Paleri MS, FRCS (Eng), FRCS(ORL-HNS)

    Corresponding author
    1. Department of Otolaryngology- Head and Neck Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
    2. Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
    • Department of Otolaryngology – Head and Neck Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, NE7 7DN, United Kingdom. E-mail: vinidh.paleri@ncl.ac.uk

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  • This work was presented at the 1st Congress of the Confederation of the European ORL-HNS, Barcelona, July 2011 (oral presentation); North of England Meeting, Darlington, March 2011 (poster); and the BAHNO meeting, London, April 2011 (poster). Terry Jones received funding from Sigmacon, Zeiss and Storz for a research fellowship in Head & Neck Surgery in Liverpool, 2009-20012. All three companies also contributed to his airfare to attend the South African ENT Congress in 2008.

Abstract

Background

The purpose of this systematic review and meta-analysis was to assess the oncological and functional outcomes of transoral laser microsurgery (TLM) in radiorecurrent laryngeal cancer.

Methods

The review was performed using search strategies including Medline, Embase, Zetoc, conference proceedings, and a manual search. Pooled estimates of local control at 24 months, disease-free survival (DFS), and overall survival (OS) rates were calculated.

Results

The pooled mean estimates were: local control rate at 24 months after first TLM (n = 249), 56.9% (95% confidence interval [CI], 47.4–66.1); local control after repeat TLM (n = 186), 63.8% (95% CI, 57.1–70.2); DFS (n = 174), 70.9% (95% CI, 60.8–80); and OS (n = 276), 74.8% (95% CI, 68.2–80.9). Pooled mean laryngeal preservation (n = 286) was 72.3% (95% CI, 68.4–76.1).

Conclusion

TLM is oncologically sound in the salvage setting with high larynx-preservation rate, but there is a trend toward inferior local control rates compared to open partial laryngectomy techniques. © 2013 Wiley Periodicals, Inc. Head Neck 36: 280–285, 2014

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