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

J Laryngol Otol. 2013 Aug;127(8):732-8. doi: 10.1017/S0022215113001400. Epub 2013 Jul 9.

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).

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Glottis / pathology
  • Glottis / surgery*
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery
  • Humans
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy*
  • Laryngeal Neoplasms / surgery*
  • Laser Therapy*
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Prognosis
  • Squamous Cell Carcinoma of Head and Neck
  • Treatment Outcome
  • Voice Quality