Xiao-Ning Luo1, Liang-Si Chen2, Si-Yi Zhang3, Zhong-Ming Lu4, Yan Huang5. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China. xiaoningluo@yeah.net. 2. Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China. liangsichencls@163.com. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China. siyizhangzsy@163.com. 4. Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China. mingzhonglulmz@126.com. 5. Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China. yanhuanghy@yeah.net.
Abstract
PURPOSE: This meta-analysis compared the efficacy of laryngectomy and three larynx-preservation treatments in patients with advanced laryngeal cancer. MATERIALS AND METHODS: Medline, Cochrane, EMBASE and Google Scholar databases were searched (until May 5, 2014) for studies that evaluated total laryngectomy followed by radiation and three larynx-preserving strategies in patients with advanced laryngeal cancer. The outcomes assessed were the 2- to 5-year overall survival (OS), disease-free survival (DFS), and laryngectomy-free survival (LFS) RESULTS: The search identified ten studies which were used for the meta-analysis (N = 2013 patients). The meta-analysis found that among different treatments, RT alone was associated with the highest rate of OS (71.6 %), DFS (57.8 %), and LFS (79.0 %). OS was similar among the following treatments: laryngectomy→RT vs. CT→RT [P = 0.402]; RT+CT vs. RT alone [P = 0.440]; and RT+CT vs CT→RT [P = 0.588]. DFS rate was higher in patients receiving laryngectomy→RT than CT→RT (P = 0.001) and was similar for RT+CT compared with CT→RT (P = 0.590). CONCLUSION: These findings suggest that of the larynx-preserving treatments, RT alone was associated with highest rates of OS, DFS, and LFS in patients with locally advanced cancer of the larynx and hypopharynx. Laryngectomy provided a better rate of DFS than CT and RT, but OS were similar across the different larynx-preserving treatments and laryngectomy.
PURPOSE: This meta-analysis compared the efficacy of laryngectomy and three larynx-preservation treatments in patients with advanced laryngeal cancer. MATERIALS AND METHODS: Medline, Cochrane, EMBASE and Google Scholar databases were searched (until May 5, 2014) for studies that evaluated total laryngectomy followed by radiation and three larynx-preserving strategies in patients with advanced laryngeal cancer. The outcomes assessed were the 2- to 5-year overall survival (OS), disease-free survival (DFS), and laryngectomy-free survival (LFS) RESULTS: The search identified ten studies which were used for the meta-analysis (N = 2013 patients). The meta-analysis found that among different treatments, RT alone was associated with the highest rate of OS (71.6 %), DFS (57.8 %), and LFS (79.0 %). OS was similar among the following treatments: laryngectomy→RT vs. CT→RT [P = 0.402]; RT+CT vs. RT alone [P = 0.440]; and RT+CT vs CT→RT [P = 0.588]. DFS rate was higher in patients receiving laryngectomy→RT than CT→RT (P = 0.001) and was similar for RT+CT compared with CT→RT (P = 0.590). CONCLUSION: These findings suggest that of the larynx-preserving treatments, RT alone was associated with highest rates of OS, DFS, and LFS in patients with locally advanced cancer of the larynx and hypopharynx. Laryngectomy provided a better rate of DFS than CT and RT, but OS were similar across the different larynx-preserving treatments and laryngectomy.
Authors: C A Mantz; E E Vokes; M S Kies; B Mittal; M E Witt; M A List; R R Weichselbaum; D J Haraf Journal: Ann Oncol Date: 2001-03 Impact factor: 32.976
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