Oncologic outcomes of transoral laser microsurgery for radiorecurrent laryngeal carcinoma: A systematic review and meta-analysis of English-language literature

BACKGROUND: The purpose of this systematic review and meta-analysis was to assess the oncological and functional outcomes of transoral laser microsurgery (TLM) in radiorecurrent laryngeal cancer.\n\nMETHODS: The review was performed using search strategies including Medline, Embase, Zetoc, conference proceedings, and a manual search. Pooled estimates of local control at 24 months, disease-free survival (DFS), and overall survival (OS) rates were calculated.\n\nRESULTS: The pooled mean estimates were: local control rate at 24 months after first TLM (n = 249), 56.9% (95% confidence interval [CI], 47.4-66.1); local control after repeat TLM (n = 186), 63.8% (95% CI, 57.1-70.2); DFS (n = 174), 70.9% (95% CI, 60.8-80); and OS (n = 276), 74.8% (95% CI, 68.2-80.9). Pooled mean laryngeal preservation (n = 286) was 72.3% (95% CI, 68.4-76.1).\n\nCONCLUSION: TLM is oncologically sound in the salvage setting with high larynx-preservation rate, but there is a trend toward inferior local control rates compared to open partial laryngectomy techniques.