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Transoral laser surgery versus radiotherapy for tumour stage 1a or 1b glottic squamous cell carcinoma: systematic review of local control outcomes

Published online by Cambridge University Press:  09 July 2013

J O'Hara ,
A Markey  and
J J Homer
J O'Hara
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Sunderland Royal Hospital, UK
A Markey
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, UK
J J Homer*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, UK Department of Otolaryngology Head and Neck Surgery, University of Manchester, UK
*
Address for correspondence: Professor Jarrod J Homer, Department of Otolarynglogy, Manchester Royal Infirmary and Christie Hospital, Oxford Road, Manchester M13 9DL, UK Fax: +44 (0)161 276 5003 E-mail: Jarrod.Homer@manchester.ac.uk
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Abstract

Background:

Previous literature reviews comparing transoral laser surgery versus radiotherapy for glottic carcinoma treatment have analysed ‘early stage’ disease as one group. The current review aimed to assess local control outcomes, comparing these two treatment modalities, specifically for either tumour stage 1a or stage 1b lesions.

Methods:

The three authors conducted independent, structured literature searches. Simple weighted means were calculated.

Results:

Thirty-six publications were analysed. Three-year local control rates for tumour stage 1a tumours were 88.9 per cent for transoral laser surgery (n = 1308) and 89.3 per cent for radiotherapy (n = 2405). For tumour stage 1b tumours, the local control rates were 76.8 per cent for transoral laser surgery (n = 194) and 86.2 per cent for radiotherapy (n = 492).

Conclusion:

From this analysis of level four evidence, there was no demonstrable difference in local control rates for tumour stage 1a glottic squamous cell carcinoma treated by transoral laser surgery or radiotherapy. There was a trend towards improved local control of tumour stage 1b tumours treated with radiotherapy, but this finding was based on a limited number of published outcomes (n = 194).

Keywords

LarynxVocal CordsCarcinomaRadiotherapyLasersSurgical ProceduresLaryngoscopicPrognosis
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 8 , August 2013 , pp. 732 - 738
Copyright
Copyright © JLO (1984) Limited 2013 

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