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PMID- 29794737
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20180612
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 21
DP  - 2018 May
TI  - Efficacy comparison between primary total laryngectomy and nonsurgical
      organ-preservation strategies in treatment of advanced stage laryngeal cancer: A 
      meta-analysis.
PG  - e10625
LID - 10.1097/MD.0000000000010625 [doi]
AB  - BACKGROUND: We aimed to provide a pooled analysis of controlled trials comparing 
      long-term survival after primary laryngectomy and primary organ preservation
      methods in patients with T3-4 laryngeal cancer. METHODS: We performed
      random-effects meta-analyses on overall survival (OS), disease-free survival
      (DFS), disease-specific survival (DSS), and locoregional control (LRC). RESULTS: 
      Fifteen studies met the selection criteria including 6288 patients (2696 patients
      who underwent primary laryngectomy and 3592 patients who underwent primary
      nonsurgical organ preservation therapy). There was a significant difference
      between the groups with respect to OS (HR 0.71, 95% CI 0.57-0.89, P = .003).
      However, a subgroup analysis found OS was not significantly worse for patients
      with T3 laryngeal cancer who received primary organ preservation compared with
      patients who underwent primary laryngectomy (HR 0.96, 95% CI 0.45-2.03, P = .91).
      There was no significant difference for DFS (HR 0.63, 95% CI 0.39-1.04, P = .07) 
      in two groups. Patients with laryngeal cancer who underwent primary laryngectomy 
      had a better DSS (HR 0.47, 95% CI 0.25-0.88, P = .02) and LRC (HR 0.56, 95% CI
      0.390.80, P = .001) than patients who underwent primary nonsurgical organ
      preservation therapy. CONCLUSION: Our results support total laryngectomy for
      patients with T4 laryngeal cancer and show that primary organ preservation for
      laryngeal cancer has no advantage and also did not decrease the rate of OS in
      patients with T3 laryngeal cancer when compared with primary total laryngectomy.
FAU - Tang, Zhao-Xian
AU  - Tang ZX
AD  - Department of ENT, Chongqing Cancer Hospital and Institute and Cancer Center,
      Chongqing, China.
FAU - Gong, Jing-Lin
AU  - Gong JL
FAU - Wang, Ya-Hui
AU  - Wang YH
FAU - Li, Zhen-Hua
AU  - Li ZH
FAU - He, Yun
AU  - He Y
FAU - Liu, Yi- Xiu
AU  - Liu YX
FAU - Zhou, Xiao-Hong
AU  - Zhou XH
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Humans
MH  - Laryngeal Neoplasms/mortality/pathology/*surgery
MH  - Laryngectomy/*methods
MH  - Larynx/pathology/surgery
MH  - Organ Preservation/*methods
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2018/05/26 06:00
MHDA- 2018/06/13 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [entrez]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
AID - 10.1097/MD.0000000000010625 [doi]
AID - 00005792-201805250-00013 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(21):e10625. doi: 10.1097/MD.0000000000010625.