Transoral laser surgery versus radiotherapy: Systematic review and meta‐analysis for treatment options of T1a glottic cancer

Abstract

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.

Voice Outcomes of Transoral Laser Microsurgery of the Larynx

“…Results are often difficult to compare among studies because of the absence of standardization of measurements, the wide range of values that can be considered in the normal range, a significant intraand interindividual variability in these measurements, and the various computer programs used. 27 In the 8 studies retained for the meta-analysis published by Abdurehim and colleagues, 10 in the TLM groups, jitter ranged from 0.74 AE 1 to 8.67 AE 2.63, and shimmer from 1.31 AE .25 to 13.4 AE 1. In most publications of acoustic analysis, a jitter value of less than 1% and a shimmer value of less than 3.8% are considered normal, and beyond these values voice may be considered pathologic.…”

Contemporary Surgical Management of Early Glottic Cancer

“…The meta-analysis published by Feng and colleagues 82 in 2011 included 5 studies reporting local control rates of T1-T2 glottic cancer and found no significant difference between the treatment modalities. Finally, Abdurehim and colleagues 83 included 10 studies in their meta-analysis of oncologic outcomes for T1a glottic cancer and found no difference between TLM and RT with regard to local control, disease-specific survival, or overall survival. Thus, for Tis, T1, and T2 glottic carcinoma, there is currently no evidence showing a difference in local control, diseasespecific survival, or organ preservation for either surgery or RT.…”

Voice Outcomes After Transoral Laser Microsurgery for Early Glottic Cancer—Considering Signal Type and Smoothed Cepstral Peak Prominence

“…8 However, there is still considerable debate regarding expected voice outcomes, [9][10][11][12] with widely varying opinion among health care providers on which modality offers the best voice outcome. 10 Despite the postoperative voice playing a significant role in treatment decision making, there is no consistent voice profile after TLM. [8][9][10] Acoustic measures of perturbation and noise have been widely used to investigate voice outcomes after TLM.…”

“…10 Despite the postoperative voice playing a significant role in treatment decision making, there is no consistent voice profile after TLM. [8][9][10] Acoustic measures of perturbation and noise have been widely used to investigate voice outcomes after TLM. 11 Perturbation measures calculate the cycle-to-cycle variations in fundamental frequency (jitter) and amplitude (shimmer) 13 and are linked to impaired vocal fold movement 14 and the perceptual quality of vocal hoarseness.…”