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Laryngectomy-free survival after salvage partial laryngectomy: a systematic review and meta-analysis

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Radiotherapy (RT) is widely used for early glottic cancer. Patients failing this treatment are referred to surgical management of their disease. Salvage partial laryngectomy (SPL) has the advantage of preserving laryngeal function with total laryngectomy (TL) remaining as a last resort. The purpose of this study was to determine the efficacy of SPL in preventing total laryngectomy, following failed RT, for early glottic cancer.

Methods

A meta-analysis of all published English literature was performed. All publications that included patients undergoing SPL were reviewed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) reporting guidelines. The search strategy identified 154 relevant articles. A total of 15 retrospective studies that included 323 suitable patients were subsequently analyzed in this meta-analysis. The main outcome measure was the rate of laryngectomy-free survival (LFS) following SPL. The indications for salvage TL (i.e., disease recurrence and poorly functional larynxes) as well as subgroup analyses for open and trans-oral SPLs were also calculated.

Results

The overall rate of LFS following SPL was 81.2% (fixed effects model range: 75.7–86.8%). Salvage TL following SPL were performed in 96.8% due to disease recurrence and in 3.2% to poorly functional larynxes. A subgroup analysis showed a 90.4% LFS after open SPL and 78.6% following trans-oral SPL.

Conclusion

A high rate of successful salvage partial laryngectomies, regardless of surgical technique, is to be anticipated in well-selected patients after RT failure.

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Author notes

  1. Udi Shapira and Anton Warshavsky have contributed equally.

Authors and Affiliations

  1. The Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, 6423906, Tel-Aviv, Israel

    Udi Shapira, Anton Warshavsky, Nidal Muhanna, Yael Oestreicher-Kedem, Yuval Nachalon, Omer J. Ungar, Ahmad Safadi, Narin N. Carmel Neiderman & Gilad Horowitz

  2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Udi Shapira, Anton Warshavsky, Nidal Muhanna, Yael Oestreicher-Kedem, Yuval Nachalon, Omer J. Ungar, Ahmad Safadi, Narin N. Carmel Neiderman & Gilad Horowitz

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Shapira, U., Warshavsky, A., Muhanna, N. et al. Laryngectomy-free survival after salvage partial laryngectomy: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 279, 3021–3027 (2022). https://doi.org/10.1007/s00405-022-07257-2

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  • DOI: https://doi.org/10.1007/s00405-022-07257-2

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