Functional outcomes after radiotherapy or laser surgery in early glottic carcinoma: A systematic review

Background: Early glottic carcinoma is treated with laser surgery or radiotherapy, but which treatment has better functional outcomes is unclear. This systematic review compared functional outcomes (voice, swallowing, QoL) in more extended T1a and limited T2 tumors a) between treatments, b) between greater and lesser laser resections. Methods: Systematic literature search covering relevant databases from 1990-2009, combining all PICO keyword variations. Results: 19 papers met the inclusion criteria, all were level IV evidence. Papers only reported voice and QoL. Heterogeneity of outcome measures prevented data pooling. Uncertainty about tumor comparability (depth, extent) between the two treatments, small subject numbers, and poor-quality reporting hindered interpretation. Conclusion: To allow comparison of laser surgery versus radiotherapy, a standardized method is needed that accurately measures tumor extent and depth. Agreement on functional outcome measures is necessary to allow comparison of treatments and resection types. Multicenter studies should be encouraged to guarantee adequate subject numbers. Otorhinolaryngolog