Survival, Surgical, and functional outcomes of transoral laser microsurgery for cT1-T3 supraglottic laryngeal Cancers: A systematic review

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-09-01 DOI:10.1016/j.oraloncology.2024.107009

Jerome R. Lechien , Stéphane Hans

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引用次数: 0

Abstract

Background

This review aimed to investigate the surgical, functional, and oncological outcomes of transoral laser microsurgery supraglottic laryngectomy (TOLM-SGL) for cT1-T3 laryngeal cancers.

Methods

PubMed, Scopus, and Cochrane Library were searched by two independent investigators for studies investigating the surgical, functional, and oncological outcomes of TOLM-SGL using the PRISMA statements. A bias analysis was carried out with MINORS.

Results

Twenty-four studies were included (937 patients), including 206 (25.9 %) cT1, 467 (58.7 %) cT2, and 123 (15.4 %) cT3 cases. Most patients were cN0 (63.9 %). The mean hospital stay of TOLM was 10.1 days. Aspiration (5.5 %), and bleeding (5.3 %) were the most prevalent complications. The laryngeal preservation rate was 93.7 %. Temporary tracheotomy was performed in 18.0 % of patients, with a mean time of decannulation of 6.8 days. A feeding tube was placed in 59.9 % of patients. The oral diet restarted after 6.4 days. Definitive gastrostomy was necessary in 2.4 % of cases. The 5-year OS and DFS were 70.1 % and 82.0 %, respectively. Distant metastasis, local, and regional recurrence occurred in 4.6 %, 11.6 %, and 5.1 % of patients. There was an important heterogeneity between studies for inclusion criteria, patient profiles, TOLM indications, and details of surgical, functional, and oncological outcomes.

Conclusion

TOLM supraglottic laryngectomy is a safe, and effective procedure associated with adequate functional, surgical, and oncological outcomes. Future studies are needed to define the place of TOLM in advanced LSCC; the role and timing of concomitant bilateral neck dissection, the indications of tracheotomy and feeding tube.

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经口激光显微手术治疗 cT1-T3 声门上型喉癌的生存、手术和功能效果：系统综述

背景本综述旨在研究经口激光显微手术声门上喉切除术（TOLM-SGL）治疗cT1-T3喉癌的手术、功能和肿瘤治疗效果。方法由两名独立研究者采用PRISMA声明在PubMed、Scopus和Cochrane图书馆检索了有关TOLM-SGL手术、功能和肿瘤治疗效果的研究。结果共纳入 24 项研究（937 例患者），包括 206 例 cT1（25.9%）、467 例 cT2（58.7%）和 123 例 cT3（15.4%）。大多数患者为 cN0（63.9%）。TOLM的平均住院时间为10.1天。吸入（5.5%）和出血（5.3%）是最常见的并发症。喉保留率为 93.7%。18.0%的患者接受了临时气管切开术，平均拆管时间为6.8天。59.9%的患者安置了喂食管。6.4 天后重新开始口服饮食。2.4%的病例需要进行最终胃造瘘术。5年的OS和DFS分别为70.1%和82.0%。4.6%、11.6%和5.1%的患者出现远处转移、局部和区域复发。结论声门上型喉切除术是一种安全、有效的手术，具有良好的功能、手术和肿瘤效果。未来的研究需要明确声门上喉切除术在晚期LSCC中的地位；同时进行双侧颈部切除术的作用和时机；气管切开术和喂食管的适应症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.