Table 5.
Comparison of outcomes between TLM and pRT in early-stage glottic cancers.
| Meta-Analysis T Categories Patients (n)/Studies (n) |
LC [HR (95-CI)] |
DSS [HR (95%-CI)] |
OS [HR (95%-CI)] |
LP [HR (95%-CI)] |
|---|---|---|---|---|
| Higgins, 2009 [41], Tis-T2 7676/26 |
0.81 (0.51–1.35) |
n.a. |
1.48 (1.19–1.85) |
TL-free survial 0.73 0.39–1.35 *2 |
| Mo, 2017 [18], T1 1238-1452/11 |
0.98 (0.7–1.38) |
n.a. |
1.35 (1.02–1.79) |
5.81 (3.36–10.05) |
| Guimaraes, 2018 [19] *1 Tis-T1a 1034-1481/6-10 |
WMD TLM vs. pRT −0.01 [−0.07, 0.04] Z = 0.45; p = 0.65 |
WMD TLM vs. pRT −0.02 [−0.04, −0.00] Z = 2.03; p = 0.04 |
WMD −0.05 [−0.09, −0.00) Z = 1.97; p = 0.05 |
WMD −0.10 [−0.13, −0.07] Z = 6.53; p < 0.00001 |
| Ding, 2019 [20], T1-T2 2480/18 |
1.19 (0.76–1.85) |
1.60 (0.89–2.88) |
1.39 1.06–1.81) |
3.85 1.92–7.72 |
| Vaculik, 2019 [21], T1 1987/17 |
1.19 0.79–1.81 |
2.70 1.32–5.54 |
1.52 1.07–2.14 |
6.31 3.77–10.56 |
TLM: transoral laser microsurgery, pRT: primary radiotherapy, LC: local control, DSS: disease-specific survival, OS: overall survival, LP: larynx preservation, HR hazard ratio, 95%-CI: 95%-confidence interval. Bolded values were statistically significant. *1 Guimaraes used the weighted means difference (WMD). The other authors expressed their results in hazard ratios (HR); *2 Laryngectomy-free survival data in Higgins meta-analysis were based on 4 among the 26 studies in which the Spector study [42] had a weight of 51.8%. This study, however, was not representative for TLM studies in general. It was published in 1999 and reports rather preliminary results from the built-up phase of laser surgery. Six patients among the 61 TLM patients (9.8%) and 29/194 pRT patients (14.9%) underwent total laryngectomy.