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Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO(2) transoral laser microsurgery and radiotherapy
BACKGROUND: The objective of this study is to compare the oncologic outcomes of CO(2) transoral laser microsurgery (TLM) and radiotherapy (RT) for treatment of T1 glottic carcinoma. METHODS: A literature search was conducted in the following databases: Medline/PubMed, Web of Science, EMBASE, and the...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6724253/ https://www.ncbi.nlm.nih.gov/pubmed/31481120 http://dx.doi.org/10.1186/s40463-019-0367-2 |
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author | Vaculik, Michael F. MacKay, Colin A. Taylor, S. Mark Trites, Johnathan R. B. Hart, Robert D. Rigby, Matthew H. |
author_facet | Vaculik, Michael F. MacKay, Colin A. Taylor, S. Mark Trites, Johnathan R. B. Hart, Robert D. Rigby, Matthew H. |
author_sort | Vaculik, Michael F. |
collection | PubMed |
description | BACKGROUND: The objective of this study is to compare the oncologic outcomes of CO(2) transoral laser microsurgery (TLM) and radiotherapy (RT) for treatment of T1 glottic carcinoma. METHODS: A literature search was conducted in the following databases: Medline/PubMed, Web of Science, EMBASE, and the Cochrane Library. Search results were screened, and publications comparing oncologic outcomes of T1N0M0 glottic carcinoma treated with TLM or RT were included. Data was extracted independently by two authors, and publication quality was graded according to the Oxford Centre for Evidence-based Medicine. Meta-analysis was performed for overall survival, disease specific survival, laryngeal preservation, and local control. RESULTS: Sixteen studies were included in the meta-analysis, the majority being retrospective cohort studies with two prospective cohort studies. Included studies were rated as either Level II or III evidence. Meta-analysis favoured treatment with TLM for T1 glottic carcinoma patients for the following outcomes: overall survival (odds ratio [OR], 1.52; 95% confidence interval [CI], 1.07–2.14; P = 0.02), disease specific survival (OR, 2.70; CI, 1.32–5.54; P = 0.007), and laryngeal preservation (OR, 6.31; CI, 3.77–10.56; P < 0.00001). There was no difference in local control between TLM and RT in T1 glottic cancer (OR, 1.19; CI, 0.79–1.81; P = 0.40). DISCUSSION: Our study provides a current and thorough comparison of TLM and RT outcomes in T1 glottic carcinoma. Limitations of our study include lack of randomized control trials, and non-randomized allocation of patients to treatment groups. Our meta-analysis suggests that TLM is the superior modality in terms of overall survival, disease specific survival, and laryngeal preservation. Future prospective randomized controlled studies are required for confirming these findings and developing appropriate clinical practice guidelines. LEVEL OF EVIDENCE: 2A; as per the Centre of Evidence Based Medicine. |
format | Online Article Text |
id | pubmed-6724253 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67242532019-09-10 Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO(2) transoral laser microsurgery and radiotherapy Vaculik, Michael F. MacKay, Colin A. Taylor, S. Mark Trites, Johnathan R. B. Hart, Robert D. Rigby, Matthew H. J Otolaryngol Head Neck Surg Original Research Article BACKGROUND: The objective of this study is to compare the oncologic outcomes of CO(2) transoral laser microsurgery (TLM) and radiotherapy (RT) for treatment of T1 glottic carcinoma. METHODS: A literature search was conducted in the following databases: Medline/PubMed, Web of Science, EMBASE, and the Cochrane Library. Search results were screened, and publications comparing oncologic outcomes of T1N0M0 glottic carcinoma treated with TLM or RT were included. Data was extracted independently by two authors, and publication quality was graded according to the Oxford Centre for Evidence-based Medicine. Meta-analysis was performed for overall survival, disease specific survival, laryngeal preservation, and local control. RESULTS: Sixteen studies were included in the meta-analysis, the majority being retrospective cohort studies with two prospective cohort studies. Included studies were rated as either Level II or III evidence. Meta-analysis favoured treatment with TLM for T1 glottic carcinoma patients for the following outcomes: overall survival (odds ratio [OR], 1.52; 95% confidence interval [CI], 1.07–2.14; P = 0.02), disease specific survival (OR, 2.70; CI, 1.32–5.54; P = 0.007), and laryngeal preservation (OR, 6.31; CI, 3.77–10.56; P < 0.00001). There was no difference in local control between TLM and RT in T1 glottic cancer (OR, 1.19; CI, 0.79–1.81; P = 0.40). DISCUSSION: Our study provides a current and thorough comparison of TLM and RT outcomes in T1 glottic carcinoma. Limitations of our study include lack of randomized control trials, and non-randomized allocation of patients to treatment groups. Our meta-analysis suggests that TLM is the superior modality in terms of overall survival, disease specific survival, and laryngeal preservation. Future prospective randomized controlled studies are required for confirming these findings and developing appropriate clinical practice guidelines. LEVEL OF EVIDENCE: 2A; as per the Centre of Evidence Based Medicine. BioMed Central 2019-09-03 /pmc/articles/PMC6724253/ /pubmed/31481120 http://dx.doi.org/10.1186/s40463-019-0367-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Research Article Vaculik, Michael F. MacKay, Colin A. Taylor, S. Mark Trites, Johnathan R. B. Hart, Robert D. Rigby, Matthew H. Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO(2) transoral laser microsurgery and radiotherapy |
title | Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO(2) transoral laser microsurgery and radiotherapy |
title_full | Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO(2) transoral laser microsurgery and radiotherapy |
title_fullStr | Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO(2) transoral laser microsurgery and radiotherapy |
title_full_unstemmed | Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO(2) transoral laser microsurgery and radiotherapy |
title_short | Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO(2) transoral laser microsurgery and radiotherapy |
title_sort | systematic review and meta-analysis of t1 glottic cancer outcomes comparing co(2) transoral laser microsurgery and radiotherapy |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6724253/ https://www.ncbi.nlm.nih.gov/pubmed/31481120 http://dx.doi.org/10.1186/s40463-019-0367-2 |
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