Risk Factors of Stomal Recurrence After Laryngectomy: A Systematic Review and Meta-analysis

Abstract

This study has confirmed a series of earlier identified factors for stomal recurrence and local recurrence following laryngectomy. Our results will provide important insights for clinical practice.

Semon Lecture: ‘Laryngectomy Practice Based on Personal Research’, Royal Society of Medicine, 5 November 2020, London, UK

“…3 Though not conclusive (as all patients received RT), the results did question whether tracheostomy caused peristomal recurrence. Given supportive evidence from studies by Rubin et al, 4 Pezier et al 5 and Mei et al, 6 we do not consider pre-operative tracheostomy to be an independent indication for post-operative radiation therapy, unless the tracheostomy tract passed through a tumour, or the tracheostomy was necessitated by subglottic extension or advanced cancer.…”

“…1 Our cohort of primary laryngectomies have provided us with an opportunity to conduct several clinical studies that have informed how we manage our laryngectomy patients. [3][4][5][6][7][8][9][10][11][12][13] Our findings are presented in relation to the following questions and topics:…”

“…(1) does tracheostomy cause peristomal recurrence? ; [3][4][5][6] (2) management of the thyroid gland with laryngectomy; [7][8][9] (3) is tracheoesophageal speech appropriate in a developing world community? ; 10,11 (4) early oral feeding following total laryngectomy; 12,13 (5) do perioperative proton pump inhibitors (PPIs) reduce the incidence of pharyngocutaneous fistulae following total laryngectomy?…”

Peristomal recurrence following primary total laryngectomy: the enigma of the central compartment neck lymph nodes

“…A systematic review and meta-analysis of research studies published between 1967 and 2016 estimates the PSR rate to be 6.6% (95% confidence interval [CI], 5.40–7.90) [3]. PSR rate was reported highest in African countries, followed by American, Asian, and European institutions [3]. The majority of cases are histologically SCC, though other varieties of laryngo-hypopharyngeal cancers have been reported [1].…”

Which risk factors are associated with stomal recurrence after total laryngectomy for laryngeal cancer? A meta-analysis of the last 30 years

“…In fact, which high-risk factors are most significant is still under debate. Although two meta-analyses have been published on this topic, 23 , 24 we consider that one study included insufficient number of studies, 23 and the other focused on the risk factors in those patients who had TL or/and partial laryngectomy. 24 Thus, we performed a systematic review and meta-analysis in order to investigate the potential risk factors for SR after TL.…”