Survival Outcomes of Transoral Microsurgery in T3/T4a Laryngeal Tumors: Systematic Review and Meta‐Analysis

Objective To critically evaluate oncological and functional outcomes following transoral laser microsurgery (TLM) in patients with T3/T4a glottic and supraglottic squamous cell carcinoma (SCC). Data Sources A comprehensive search of five major databases—PubMed, Embase, Scopus, ScienceDirect, and Web...

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Bibliographic Details
Published in:The Laryngoscope 2025-01, Vol.135 (1), p.15-26
Main Authors: Vasudevan, Srivatsa Surya, Zulli, Adam, Olinde, Lindsay, Pang, John, Nathan, Cherie‐Ann O., Asarkar, Ameya A.
Format: Article
Language:English
Subjects:
advanced laryngeal tumors
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Disease-Free Survival
Glottis - pathology
Glottis - surgery
Humans
Laryngeal Neoplasms - mortality
Laryngeal Neoplasms - pathology
Laryngeal Neoplasms - surgery
Laser Therapy - methods
meta‐analysis
Microsurgery
Microsurgery - methods
Natural Orifice Endoscopic Surgery - methods
Neoplasm Staging
oncologic outcome
Ostomy
prognosis
recurrence
survival
Survival Rate
Systematic review
Treatment Outcome
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Summary:Objective To critically evaluate oncological and functional outcomes following transoral laser microsurgery (TLM) in patients with T3/T4a glottic and supraglottic squamous cell carcinoma (SCC). Data Sources A comprehensive search of five major databases—PubMed, Embase, Scopus, ScienceDirect, and Web of Science—was conducted using a combination of relevant keywords and MeSH terms. Review Methods Systematic review and meta‐analysis of odds ratio (OR), hazards ratio (HR), and proportion, focusing on oncological and functional outcomes of TLM in advanced T3/T4a glottic and supraglottic tumors. A random‐effects meta‐analysis model was employed. Results The review incorporated 29 cohort studies, representing a total of 1,897 patients undergoing TLM for T3/T4a glottic and supraglottic SCC. The cumulative 5‐year disease‐free survival (DFS) rate for T3 glottic and supraglottic tumors was 44.4% (95% CI: 47–66%) and 62.8% (95% CI: 63–81%), while the 5‐year DFS for T4 glottic and supraglottic tumors was 41.1% (95% CI: 33.4–49.2%) and 32.9% (95% CI: 19.3–50.1%), respectively. T3 glottic tumors exhibited a 2.5‐fold significantly higher odds of local recurrence post‐TLM compared to their T3 supraglottic tumors (95% CI: 1.6–3.9, p 
ISSN:0023-852X
1531-4995
1531-4995
DOI:10.1002/lary.31695