Transoral laser surgery versus radiotherapy: systematic review and meta-analysis for treatment options of T1a glottic cancer.

BACKGROUND: The objective of this study was to conduct a systematic review and meta-analysis to compare the oncologic and functional outcomes between transoral laser surgery (TLS) and radiotherapy (RT).

METHODS: An electronic library search of the relevant English- and Chinese-language literature was conducted. Potentially eligible articles were reviewed. Qualified articles were selected and evaluated.

RESULTS: No significant differences were identified between TLS and RT with respect to local control, overall survival, disease-specific survival, and posttreatment voice quality. However, larynx preservation was significantly higher in patients initially treated with TLS than those initially treated with RT.

CONCLUSIONS: The approach for optimal treatment of T1a glottic cancer remains unanswered. This results from the relatively inconclusive evidence obtained from the current literature. Properly designed, prospective, randomized, or well-controlled studies will be required. Similar methodologies for treatment and reporting need to be established to make a valid and meaningful comparison between studies.