A Meta-analysis Of Partial Laryngectomy And Total Laryngectomy In The Treatment Of Advanced-stage Laryngeal Carcinoma

Objective:By means of systematic analysis method,to comparise the long-term effect between partial laryngectomy and total laryngectomy in the treatment of advanced-stage laryngeal carcinoma,in order to discuss the rationality and feasibility of partial laryngectomy and provide evidence-based medicine for the clinical practice.Methods:Case control studies of partial laryngectomy and total laryngectomy in the treatment of advanced-stage laryngeal carcinoma were searched from PubMed/Medline database,Springerlink,Wanfang database,Chinese Journal Full-text Database(CNKI),Chinese PSTP(VIP),and so on.The search time ended up to December 2016.Using the Newcastle Ottawa scale(NOS)to evaluate the quality of each literature.Using the evaluation software RevMan5.3 which provided by the Cochrane collaboration network to do a Meta-analysis.Choosing the corresponding effect model according to heterogeneity test results.For dichotomous data,results were expressed as Odds Ratio(OR)and 95% confidence interval(95%CI),and do the funnel plot to evaluate publication bias.Results:12 articles(1093 patients)were eligibled to the inclusion criteria and were case control studies.There are 615 patients in the partial laryngectomy group(observation group),478 patients in the total laryngectomy group(control group).The Meta-analysisresults showed that:(1)the 3 year survival rate: [OR=0.80,95%CI(0.57,1.11),P=0.18],had no statistical difference between partial laryngectomy group(observation group)and total laryngectomy group(control group)in the treatment of advanced-stage laryngeal carcinoma(P> 0.05);(2)the 5 year survival rate: [OR=0.93,95%CI(0.71,1.22),P =0.58],had no statistical difference of curative effect between the two groups(P>0.05);(3)the 5 year tumor recurrence rate: [OR=1.39,95%CI(0.72,2.67),P = 0.32],had no statistical difference of curative effect between the two groups(P>0.05).There was no significant difference between the two treatments in the long-term prognosis of advanced-stage laryngeal carcinoma.Conclusion:The long-term prognosis(survival rate,tumor recurrence rate)after partial laryngectomy has no significant difference with total laryngectomy.With strict application of surgical indication,the partial laryngectomy will not reduce the long-term prognosis and retain laryngeal function(pronunciation?breathing and swallowing)for advanced-stage laryngeal carcinoma,which can ensure a higher post-operative quality of life.