Meta Analysis Of Different Surgical Treatment For Early Glottic Cancer With Anterior Commissure Involvement

Objective:By means of systematic analysis method, assessment of treatment effect about CO₂ laser surgery for early glottic cancer with anterior commissure involvement and without anterior commissure involvement, and assessment of treatment effect about CO₂ laser surgery with open surgery for early glottic cancer with anterior commissure involvement, in order to provide evidence-based medicine for the surgeon.Methods:Searching CBM, CNKI, wanfang, VIP, Central, Pub Med, EMBASE, OVID, Springer to obtain all the document about CO₂ laser treatment and open surgery for early glottic cancer at home and abroad. At the same time, using Revman 5.0 software for meta analysis about related literature according included and excluded standards. The searching time ended up to January,2015.Results:According to the retrieval strategy,16 references was retrieved, and all of them are retrospective controlled clinical trials, all of them are divided into tow parts.One part:14 literatures are included, a total of 1900 cases of the object of study. The research is divided into five comparison groups.（1）Meta analysis points out that local recurrence rate of anterior commissure+ was significantly higher than that of anterior commissure-[0R=3.00,95%CI（2.31,3.89）,P<0.00001].Local recurrence rate between anterior commissure+ and anterior commissure- in Tis stage and T1 b stage was without any statistical significance, that in T1 a and T2 stage was with statistical significance.The other part: 2 literatures are included, a total of 200 cases of the object of study,（1）five year local control rate has significant statistical differences[OR=2.58, 95%CI（1.11,5.98）,P=0.03].（2）five year disease-related survival rate has no significant statistical differences[OR=1.12, 95%CI（0.49,2.56）, P=0.79].Conclusion:The existing results show（1）local recurrence of CO₂ laser surgery for early glottic cancer was related with anterior commissure involvement.（2） For early glottic cancer with anterior commissure involvement, postoperative effect of open surgery is better than laser surgery.