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American Journal of Otolaryngology 2023To systematically evaluate differences in swallowing disorder-related manifestations in patients with supraglottic laryngeal cancer, who underwent traditional open... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically evaluate differences in swallowing disorder-related manifestations in patients with supraglottic laryngeal cancer, who underwent traditional open partial horizontal laryngectomy (OPHL) and endoscopic supraglottic laryngectomy (ESL).
METHODS
A systematic review of the literature and a meta-analysis were performed. The CNKI, Wan Fang, PubMed, EMBASE, Cochrane Library, Web of Science, and Clinical Trials databases for clinical studies data sources were investigated. The efficiency of recovery, postoperative swallowing function, and complications related to dysphagia were investigated to compare the effects of surgical procedures.
RESULTS
The meta-analysis included 8 studies with 281 patients. ESL surgery played a positive role in the recovery of patients. Preservation of the anterior epiglottic space, ventricular band, and arytenoid cartilage without destroying the external framework of the larynx can effectively reduce the risk of aspiration pneumonia in patients.
CONCLUSIONS
ESL has advantages in postoperative recovery and retention of swallowing function in patients with supraglottic laryngeal cancer.
Topics: Humans; Carcinoma; Deglutition; Deglutition Disorders; Laryngeal Neoplasms; Laryngectomy; Larynx; Retrospective Studies; Treatment Outcome
PubMed: 36706715
DOI: 10.1016/j.amjoto.2023.103788 -
Head & Neck Jul 2021In this systematic review, we aim to identify prognostic imaging variables of recurrent laryngeal or hypopharyngeal carcinoma after chemoradiotherapy. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In this systematic review, we aim to identify prognostic imaging variables of recurrent laryngeal or hypopharyngeal carcinoma after chemoradiotherapy.
METHODS
A systematic search was performed in PubMed and EMBASE (1990-2020). The crude data and effect estimates were extracted for each imaging variable. The level of evidence of each variable was assessed and pooled risk ratios (RRs) were calculated.
RESULTS
Twenty-two articles were included in this review, 17 on computed tomography (CT) and 5 on magnetic resonance imaging (MRI) variables. We found strong evidence for the prognostic value of tumor volume at various cut-off points (pooled RRs ranging from 2.09 to 3.03). Anterior commissure involvement (pooled RR 2.19), posterior commissure involvement (pooled RR 2.44), subglottic extension (pooled RR 2.25), and arytenoid cartilage extension (pooled RR 2.10) were also strong prognostic factors.
CONCLUSION
Pretreatment tumor volume and involvement of several subsites are prognostic factors for recurrent laryngeal or hypopharyngeal carcinoma after chemoradiotherapy.
Topics: Chemoradiotherapy; Humans; Hypopharyngeal Neoplasms; Larynx; Neoplasm Staging; Prognosis
PubMed: 33797818
DOI: 10.1002/hed.26698 -
European Radiology Jul 2020To compare the diagnostic performance of contrast-enhanced CT with that of MRI in the detection of cartilage invasion in patients with laryngo-hypopharyngeal cancer. (Meta-Analysis)
Meta-Analysis
Comparison of diagnostic performance between CT and MRI for detection of cartilage invasion for primary tumor staging in patients with laryngo-hypopharyngeal cancer: a systematic review and meta-analysis.
OBJECTIVE
To compare the diagnostic performance of contrast-enhanced CT with that of MRI in the detection of cartilage invasion in patients with laryngo-hypopharyngeal cancer.
METHODS
A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting diagnostic accuracy of CT and/or MRI in detecting cartilage invasion from laryngo-hypopharyngeal cancer between 2000 and 2018. The pooled sensitivity and specificity, and their 95% confidence intervals were calculated for CT and MRI using bivariate random effects modeling. Subgroup and meta-regression analyses were performed. Indirect comparison was also performed by univariable meta-regression.
RESULT
Fourteen articles including 776 patients were included in the systematic review and meta-analysis: eight for CT, and six for MRI. CT and MRI showed pooled sensitivities of 66% (95% CI, 49-80%) and 88% (95% CI, 79-93%), and pooled specificities of 90% (95% CI, 82-94%) and 81% (95% CI, 76-84%), respectively. MRI showed significantly higher sensitivity than CT (p = 0.02). The specificities showed no statistically significant difference between CT and MRI (p = 0.39). The CT studies showed heterogeneity and a threshold effect, while MRI showed neither heterogeneity nor threshold effect. In the meta-regression analysis for CT, the type of cartilage analyzed (thyroid only vs. thyroid/cricoid/arytenoid, p < 0.001) was a significant factor influencing the heterogeneity in the diagnostic performance of the CT studies.
CONCLUSIONS
In conclusion, MRI has significantly higher sensitivity than CT for detecting cartilage invasion in patients with laryngo-hypopharyngeal cancer, without a significant difference in the specificity.
KEY POINTS
• MRI has significantly higher sensitivity than CT for detecting cartilage invasion in patients with laryngo-hypopharyngeal cancer.
Topics: Cartilage; Humans; Hypopharyngeal Neoplasms; Magnetic Resonance Imaging; Neoplasm Invasiveness; Neoplasm Staging; Tomography, X-Ray Computed
PubMed: 32152744
DOI: 10.1007/s00330-020-06718-8