Transoral Laser Microsurgery Versus Radiotherapy for T1-T2 Glottic Cancer with Anterior Commissure Involvement: A...

Area of Science:

• Otolaryngology
• Oncology
• Surgical Oncology

Background:

• Early glottic tumors with anterior commissure involvement (ACI) present unique treatment challenges.
• Treatment modality selection impacts oncological and functional outcomes.
• Transoral laser microsurgery (TLM) and radiation therapy (RT) are primary treatment options.

Purpose of the Study:

• To compare the oncological and functional outcomes of TLM versus RT for early glottic tumors with ACI.
• To identify the most effective treatment for favorable outcomes in this patient population.

Main Methods:

• A systematic review and random-effects proportional meta-analysis.
• Searched PubMed, Embase, Web of Science, and ScienceDirect databases.
• Included 40 studies with 2666 patients (T1-T2 glottic cancer with ACI).

Main Results:

• TLM demonstrated superior 5-year overall survival (84.5% vs. 79.4%) and 3-year disease-free survival (82.7% vs. 73.3%) compared to RT.
• TLM showed better 5-year local control rates (77.2% vs. 71.6%) and higher laryngeal preservation rates (93% vs. 87.6%).
• Temporal analysis revealed comparable oncological outcomes between TLM and RT from 2013-2024.

Conclusions:

• TLM offers superior 5-year overall survival and laryngeal preservation for early glottic tumors with ACI compared to upfront RT.
• Both TLM and RT demonstrate comparable oncological outcomes in recent years (2013-2024).
• This meta-analysis is the first to directly compare TLM and RT outcomes in this specific patient group.