Treatment of advanced laryngeal cancer and quality of life. Systematic review

Abstract

Introduction and objectives: The objective was the comparison of the quality of life in patients with advanced laryngeal cancer treated with organ preservation versus surgical treatment.

Methods: We performed a systematic review in the databases MedLine, EMBASE, and PubMed (2014 1991) and Web of Science (2012 - 2014). The search terms were: Laryngeal cancer, organ preservation, chemotherapy, laryngectomy, treatment outcomes and quality of life. Systematic reviews, meta-analysis, reports of health technology assessment and comparative studies with control group, published in Spanish, French or English were included. The selection and quality assessment was made by two researchers. The criteria of the Cochrane Collaboration were used to assess the risk of bias and Scottish Intercollegiate Guidelines Network (SIGN) for the level of evidence.

Results: Of the 208 studies identified in the search, three were included a clinical trial and two observational studies, with a total of 211 patients. Quality and level of evidence was low. The results were contradictory, on occasion they favoured surgery, and on other occasions chemotherapy, but in general there were no statistical differences between the treatments. The studies were heterogeneous, with different methodology, undersized, limitations in quality with high risk of bias and use of different measurement scales.

Conclusions: There are not enough studies of quality to establish differences in the quality of life in patients with advanced laryngeal cancer according to the treatment received.

Keywords: Calidad de vida; Chemotherapy; Cáncer de laringe; Laringectomía; Laryngeal neoplasms; Laryngectomy; Organ preservation; Preservación de órgano; Quality of life; Quimioterapia; Supervivencia; Survival.