Role of endolaryngeal surgery (with or without laser) versus radiotherapy in the management of early (T1) glottic cancer: a systematic review.

ABSTRACT

BACKGROUND: Treatment options for early glottic cancer include transoral microsurgery or radiotherapy (RT). There is continuing debate about which is the superior treatment. METHODS: The literature was searched from 1996 to 2011 using MEDLINE, EMBASE, and Cochrane Library. A quality assessment of each included study was conducted and reported. RESULTS: There is no evidence in favor of 1 treatment modality when considering likelihood of local control or overall survival. There is a suggestion that RT may be associated with less measureable perturbation of voice as compared to surgery, but no significant differences were seen in patient perception. The likelihood of laryngeal preservation may be higher when surgery can be offered as initial treatment. CONCLUSION: For patients with early (T1) glottic cancer, treatment options include the equally effective endolaryngeal surgery, with or without laser, or radiation therapy. The choice between treatment modalities should be based on patient and clinician preferences and general medical condition.