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Oncological and Functional Outcomes for Horizontal Glottectomy: A Systematic Review
Matteo Fermi1,2, Alfredo Lo Manto3, Cecilia Lotto1
1Department of Otorhinolaryngology Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy.
Journal of Clinical Medicine
|March 29, 2023
Summary
Horizontal glottectomy (HG) offers a safe oncological outcome for glottic tumors involving the anterior commissure. This partial laryngectomy demonstrates comparable results to other treatments, preserving the larynx in most cases.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Oncology
Background:
- Horizontal glottectomy (HG) is a surgical procedure for glottic tumors with anterior commissure involvement.
- Assessing the functional and oncological outcomes of HG is crucial for treatment planning.
Purpose of the Study:
- To systematically review the literature on the functional and oncological outcomes of horizontal glottectomy.
- To evaluate HG as a treatment option for laryngeal squamous cell carcinoma.
Main Methods:
- Systematic review adhering to PRISMA 2009 guidelines.
- Inclusion of 14 articles from 19 identified, encompassing 420 patients with laryngeal squamous cell carcinoma treated with HG.
- Analysis of oncological outcomes (recurrence rates) and functional outcomes (laryngeal preservation, feeding tube/tracheostomy duration, hospitalization).
Main Results:
- The study population included 420 patients, with 339 staged as T1.
- A total of 55 recurrences were observed (35 local, 12 regional, 8 distant), resulting in a laryngeal preservation rate of 93.6%.
- Average durations for nasogastric tube removal (10.1 days), tracheostomy maintenance (11.3 days), and hospitalization (11.7 days) were reported.
Conclusions:
- Horizontal glottectomy is an oncologically safe procedure for T1a-T1b glottic tumors, with outcomes comparable to alternative treatments.
- HG is a viable therapeutic option when radiotherapy is contraindicated, refused by the patient, or when laryngeal exposure is poor.
