Abstract：
To determine the oncological outcomes of salvage transoral laser microsurgery (TLM) in the treatment of patients suffering from recurrent laryngeal cancer.
PubMed/MEDLINE, Cochrane Library, and Scopus databases were searched. English language, original studies investigating oncological outcomes of TLM in adult patients with recurrent laryngeal cancer were included. Data were pooled using a distribution-free approach for estimating summary local control (LC), disease-specific survival (DSS), and overall survival (OS) curves with random effects.
Two hundred and thirty-five patients underwent salvage TLM after primary (chemo)radiotherapy. The mean follow-up time was 60.8 months (95% CI: 32.7-88.9). Estimated pooled LC rates (95% CI) at 1, 3 and 5 years were 74.2% (61.7-89.4), 53.9% (38.5-75.3), and 39.1% (25.2-60.8). Estimated pooled DSS rates (95% CI) at 1, 3 and 5 years were 88.4% (82.0-95.3), 67.8% (50.9-90.3), and 58.9% (42.7-81.1). Two hundred and seventy-one patients underwent TLM after primary laser treatment. The mean follow-up time was 70.9 months (95% CI: 36.9-104.9). Estimated pooled LC rates (95% CI) at 1, 3 and 5 years were 72.2% (64.7-80.6), 53.2% (42.2-66.9), and 40.4% (29.6-55.2). Estimated pooled DSS rates (95% CI) at 1, 3 and 5 years were 92.1% (85.5-99.1), 77.0% (64.4-92.0), and 67.1% (51.6-87.3).
TLM is a valuable treatment option for the management of locally recurrent laryngeal carcinoma if performed by experienced surgeons and following rigorous patients\' selection criteria. Further studies should be conducted to define stage-based clinical guidelines.
NA Laryngoscope, 133:1425-1433, 2023.
PubMed/MEDLINE, Cochrane Library, and Scopus databases were searched. English language, original studies investigating oncological outcomes of TLM in adult patients with recurrent laryngeal cancer were included. Data were pooled using a distribution-free approach for estimating summary local control (LC), disease-specific survival (DSS), and overall survival (OS) curves with random effects.
Two hundred and thirty-five patients underwent salvage TLM after primary (chemo)radiotherapy. The mean follow-up time was 60.8 months (95% CI: 32.7-88.9). Estimated pooled LC rates (95% CI) at 1, 3 and 5 years were 74.2% (61.7-89.4), 53.9% (38.5-75.3), and 39.1% (25.2-60.8). Estimated pooled DSS rates (95% CI) at 1, 3 and 5 years were 88.4% (82.0-95.3), 67.8% (50.9-90.3), and 58.9% (42.7-81.1). Two hundred and seventy-one patients underwent TLM after primary laser treatment. The mean follow-up time was 70.9 months (95% CI: 36.9-104.9). Estimated pooled LC rates (95% CI) at 1, 3 and 5 years were 72.2% (64.7-80.6), 53.2% (42.2-66.9), and 40.4% (29.6-55.2). Estimated pooled DSS rates (95% CI) at 1, 3 and 5 years were 92.1% (85.5-99.1), 77.0% (64.4-92.0), and 67.1% (51.6-87.3).
TLM is a valuable treatment option for the management of locally recurrent laryngeal carcinoma if performed by experienced surgeons and following rigorous patients\' selection criteria. Further studies should be conducted to define stage-based clinical guidelines.
NA Laryngoscope, 133:1425-1433, 2023.
摘要：
目的：确定经口激光显微手术（TLM）治疗喉癌患者的肿瘤学结果。
方法：PubMed/MEDLINE，科克伦图书馆,搜索了Scopus数据库。英语语言,纳入了调查喉癌成年患者TLM肿瘤学结局的原始研究.使用无分布方法汇总数据，以估计汇总局部控制(LC)，疾病特异性生存率（DSS），和具有随机效应的总生存期(OS)曲线。
结果：二百三十五例患者在初次（化学）放疗后接受了挽救性TLM。平均随访时间为60.8个月（95％CI：32.7-88.9）。1、3和5年的估计合并LC率（95%CI）为74.2%（61.7-89.4），53.9%（38.5-75.3），和39.1%（25.2-60.8）。1、3和5年的估计合并DSS率（95%CI）为88.4%（82.0-95.3），67.8%（50.9-90.3），和58.9%（42.7-81.1）。在初级激光治疗后，共有二百七十一名患者接受了TLM。平均随访时间为70.9个月（95％CI：36.9-104.9）。1、3和5年的估计合并LC率（95%CI）为72.2%（64.7-80.6），53.2%（42.2-66.9），和40.4%（29.6-55.2）。1年、3年和5年的估计合并DSS率(95%CI)为92.1%(85.5-99.1)，77.0%（64.4-92.0），和67.1%（51.6-87.3）。
结论：如果由有经验的外科医生进行并遵循严格的患者选择标准，TLM是治疗局部复发性喉癌的一种有价值的治疗选择。应进行进一步的研究以确定基于阶段的临床指南。
方法：NA喉镜，133：1425-1433，2023年。
方法：PubMed/MEDLINE，科克伦图书馆,搜索了Scopus数据库。英语语言,纳入了调查喉癌成年患者TLM肿瘤学结局的原始研究.使用无分布方法汇总数据，以估计汇总局部控制(LC)，疾病特异性生存率（DSS），和具有随机效应的总生存期(OS)曲线。
结果：二百三十五例患者在初次（化学）放疗后接受了挽救性TLM。平均随访时间为60.8个月（95％CI：32.7-88.9）。1、3和5年的估计合并LC率（95%CI）为74.2%（61.7-89.4），53.9%（38.5-75.3），和39.1%（25.2-60.8）。1、3和5年的估计合并DSS率（95%CI）为88.4%（82.0-95.3），67.8%（50.9-90.3），和58.9%（42.7-81.1）。在初级激光治疗后，共有二百七十一名患者接受了TLM。平均随访时间为70.9个月（95％CI：36.9-104.9）。1、3和5年的估计合并LC率（95%CI）为72.2%（64.7-80.6），53.2%（42.2-66.9），和40.4%（29.6-55.2）。1年、3年和5年的估计合并DSS率(95%CI)为92.1%(85.5-99.1)，77.0%（64.4-92.0），和67.1%（51.6-87.3）。
结论：如果由有经验的外科医生进行并遵循严格的患者选择标准，TLM是治疗局部复发性喉癌的一种有价值的治疗选择。应进行进一步的研究以确定基于阶段的临床指南。
方法：NA喉镜，133：1425-1433，2023年。
