title: Oncologic outcomes of transoral laser microsurgery for radiorecurrent laryngeal carcinoma: a systematic review and meta-analysis of English-language literature.
abstract: BACKGROUND
  The purpose of this systematic review and meta-analysis was to assess the oncological and functional outcomes of transoral laser microsurgery (TLM) in radiorecurrent laryngeal cancer.
  
  
  METHODS
  The review was performed using search strategies including Medline, Embase, Zetoc, conference proceedings, and a manual search. Pooled estimates of local control at 24 months, disease-free survival (DFS), and overall survival (OS) rates were calculated.
  
  
  RESULTS
  The pooled mean estimates were: local control rate at 24 months after first TLM (n = 249), 56.9% (95% confidence interval [CI], 47.4-66.1); local control after repeat TLM (n = 186), 63.8% (95% CI, 57.1-70.2); DFS (n = 174), 70.9% (95% CI, 60.8-80); and OS (n = 276), 74.8% (95% CI, 68.2-80.9). Pooled mean laryngeal preservation (n = 286) was 72.3% (95% CI, 68.4-76.1).
  
  
  CONCLUSIONS
  TLM is oncologically sound in the salvage setting with high larynx-preservation rate, but there is a trend toward inferior local control rates compared to open partial laryngectomy techniques.
authors.affiliation: Department of Otolaryngology- Head and Neck Surgery, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Department of Otolaryngology- Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
authors.forename: Yujay
authors.initials: Y
authors.lastname: Ramakrishnan
authors.forename: Mike
authors.initials: M
authors.lastname: Drinnan
authors.forename: Foon Ng Kee
authors.initials: FN
authors.lastname: Kwong
authors.forename: David G
authors.initials: DG
authors.lastname: Grant
authors.forename: Hisham
authors.initials: H
authors.lastname: Mehanna
authors.forename: Terry
authors.initials: T
authors.lastname: Jones
authors.forename: Vinidh
authors.initials: V
authors.lastname: Paleri
mesh_terms: D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D053685:Laser Therapy / Q000379:methods; D008866:Microsurgery / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D016896:Treatment Outcome
keywords: glottis cancer; meta-analysis; radiorecurrent laryngeal carcinoma; radiotherapy; transoral laser microsurgery