A comparison of the survival between laser surgery and radiation in T(1a)N(0)M(0) glottic cancer: a population-based analysis and meta-analysis.

OBJECTIVE: The objective of this study is to compare the overall survival (OS) and the cancer-specific survival (CSS) for patients of T(1a)N(0)M(0) glottic cancer who underwent laser surgery (LS) or radiation (RT). METHODS: The data of the population-based analysis were extracted from the SEER database. The studies of the meta-analysis were identified through PubMed, EMBASE, and Cochrane databases. Cox regression analyses, the propensity score analysis (PSM), survival analyses, and the meta-analysis were performed. RESULTS: In the population-based analysis, 2101 eligible patients were included. Multivariable Cox analyses indicated that patients accepting LS alone would obtain better OS (HR 0.77, 95% CI 0.61-0.98, p = 0.03) and CSS (HR 0.26, 95% CI 0.12-0.59, p = 0.001) than those of whom they accepted RT alone. Survival analyses before PSM and after PSM also indicated that patients who underwent LS alone would have better OS and CSS. In the meta-analysis, nine eligible studies were included. Results of the pooled effect showed that significant differences existed between LS and RT groups on OS (OR: 1.84, 95% CI 1.36-2.50, p < 0.001) and CSS (OR 3.84, 95% CI 1.17-12.52, p = 0.026), both distinctly favoring LS. CONCLUSIONS: Compared with RT, LS may acquire better survivals for patients with T(1a)N(0)M(0) glottic cancer. Simultaneously, more multi-center randomized controlled trials would be warranted to prove the conclusion.