title: Oncologic outcomes of open conservation laryngectomy for radiorecurrent laryngeal carcinoma: a systematic review and meta-analysis of English-language literature.
abstract: BACKGROUND
  The role of open conservation (partial) laryngeal surgery in radiorecurrent laryngeal cancers is unclear, and the procedure is not widely accepted or practiced. The objective of this review was to assess the oncologic and functional outcomes of partial laryngectomy in radiorecurrent tumors of the larynx reported in the literature.
  
  
  METHODS
  The systematic review was performed using independently developed search strategies and included Medline, Embase, Zetoc, conference proceedings, and, when appropriate, a manual search. Inclusion criteria for the articles were set a priori. All included articles were subjected to quality assessment. Pooled estimates of local control at 24 months and of disease-free and overall survival rates were calculated using both a fixed-effects model (inverse square) and a random-effects model (DerSimonian-Laird).
  
  
  RESULTS
  The search identified 401 publications, of which 26 studies satisfied all inclusion criteria. Ten studies had a quality score ≥6 (good), and 16 had a score of 4 or 5 (fair). The pooled estimates of oncologic outcomes using the random-effects model were as follows: The local control rate at 24 months for 560 patients was 86.9% (95% CI, 84%-89.5%), the disease-free survival rate for 352 patients was 91.2% (95% CI, 88.2%-93.9%), and the overall survival rate for 360 patients was 83.1% (95% CI, 79.1%-86.7%). Decannulation of tracheostomy occurred in 95.1% (95% CI, 92.6%-97.2%) of the patients who were analyzed (n = 315), whereas the pooled mean larynx preservation rate was 83.9% (95% CI, 80.7%-87%; n = 502)
  
  
  CONCLUSIONS
  The current results indicated that open partial laryngectomies are oncologically sound procedures in the salvage setting and have a high larynx preservation rate.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, United Kingdom. vinidh.paleri@ncl.ac.uk
authors.forename: Vinidh
authors.initials: V
authors.lastname: Paleri
authors.forename: Ligy
authors.initials: L
authors.lastname: Thomas
authors.forename: Natesh
authors.initials: N
authors.lastname: Basavaiah
authors.forename: Mike
authors.initials: M
authors.lastname: Drinnan
authors.forename: Hisham
authors.initials: H
authors.lastname: Mehanna
authors.forename: Terry
authors.initials: T
authors.lastname: Jones
mesh_terms: D003413:Cricoid Cartilage / Q000601:surgery; D018572:Disease-Free Survival; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D014139:Tracheostomy; D016896:Treatment Outcome