Abstract：
Total glossectomy with laryngectomy (TGL) is a procedure with high morbidity/mortality risks reserved for cases of advanced tongue cancer with laryngeal invasion. This technique is controversial as there are significant impacts on quality of life, including loss of functional speech and swallowing. A systematic review was performed following the PRISMA guidelines with the primary goal of quantifying the functional outcomes and overall survival of patients undergoing TGL. The initial search resulted in 748 studies; seven of these met the inclusion criteria. Five studies evaluated functional speech postoperatively, and 12.1% (8/66) of patients in these studies achieved a form of functional speech. Most studies did not refer to the use of specific postoperative voice rehabilitation. Regarding swallowing function, 53.3% (32/60) of patients in five studies regained their ability to swallow. In six studies reporting gastrostomy tube dependence, 37.7% (29/77) of patients were tube-dependent. Recurrence within 1-year was reported in three studies; 52% (26/50) of the patients had recurrence within 1 year, and the 1-year disease-free survival rate was 48%. TGL is a highly invasive surgery; postoperatively, most patients do not regain the ability to speak, while only half are able to swallow. Despite these extreme efforts and sacrifices by the patient, approximately half of patients have a recurrence within the first year. The decision to perform a TGL should be made only in select and motivated patients after carefully explaining and weighing the oncological and quality of life risks and benefits.
摘要：
全舌切除术和喉切除术（TGL）是一种高发病率/死亡率风险的手术，适用于晚期舌癌伴喉部浸润的病例。这项技术是有争议的，因为对生活质量有重大影响，包括失去功能性言语和吞咽。根据PRISMA指南进行系统评价，主要目标是量化接受TGL的患者的功能结局和总体生存率。最初的搜索导致748项研究；其中7项符合纳入标准。五项研究评估了术后功能性言语，在这些研究中，12.1%(8/66)的患者达到了一种功能性言语形式。大多数研究没有提到使用特定的术后语音康复。关于吞咽功能，5项研究中53.3%(32/60)的患者恢复了吞咽能力。在六项报告胃造瘘管依赖的研究中，37.7%(29/77)的患者为管依赖性。3项研究报告了1年内复发；52%(26/50)的患者在1年内复发，1年无病生存率为48%。TGL是一种高侵入性手术；术后，大多数病人没有恢复说话的能力，而只有一半能够吞咽。尽管病人做出了这些极端的努力和牺牲，大约一半的患者在第一年内复发。只有在仔细解释和权衡肿瘤和生活质量的风险和益处后，才应在选择和有动机的患者中做出执行TGL的决定。
