Evidence map›Paper›PMID 40968204›Full record

SynthesisEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Survival and larynx function after upfront vs. salvage total laryngectomy: a meta-analysis.

Rami Saade, Caroline Jabbour, Elias Keyrouz, Jana Hassan, Bassel El Baba, Anita El Hajj, Hady Ghanem

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rami SaadeDepartment of Otolaryngology Head & Neck Surgery, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University Medical Center, Beirut, Lebanon. Rami.saade@laumcrh.com.ORCID http://orcid.org/0000-0003-1495-2005
Caroline JabbourRadiation Oncology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University Medical Center, Beirut, Lebanon.
Elias KeyrouzDepartment of Otolaryngology Head & Neck Surgery, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University Medical Center, Beirut, Lebanon.
Jana HassanDepartment of Otolaryngology Head & Neck Surgery, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University Medical Center, Beirut, Lebanon.
Bassel El BabaDepartment of Otolaryngology Head & Neck Surgery, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University Medical Center, Beirut, Lebanon.
Anita El HajjSpeech Language Pathology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University Medical Center, Beirut, Lebanon.
Hady GhanemDivision of Hematology and Oncology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University Medical Center, Beirut, Lebanon.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLaryngeal cancer is a major malignancy in head and neck oncology, with total laryngectomy (TL) as a key intervention for advanced and recurrent disease. This systematic review and meta-analysis compare primary total laryngectomy (PTL) and salvage total laryngectomy (STL) in survival, functional outcomes, and complications.

methodsA comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted up to January 18, 2025. Studies comparing PTL and STL were included based on predefined eligibility criteria. Data extraction and quality assessment were performed independently by two reviewers. Random-effects models were used to calculate pooled odds ratios (ORs) and mean differences (MDs), with heterogeneity assessed via I² statistics. Sensitivity analyses ensured result robustness.

resultsThirteen studies (2,704 patients: 913 STL, 1,791 PTL) met inclusion criteria. PTL showed significantly higher overall survival at 1 year (OR = 2.21; 95% CI: 1.38-3.55), 2 years (OR = 1.95; 95% CI: 1.40-2.71), and 3 years (OR = 1.64; 95% CI: 1.10-2.47). STL had higher risks of pharyngocutaneous fistula (OR = 2.78; 95% CI: 1.96-3.95) and reconstructive surgery (OR = 0.11; 95% CI: 0.02-0.75). PTL significantly reduced swallowing difficulty (OR = 0.12; 95% CI: 0.05-0.28) and hypopharyngeal stricture (OR = 0.14; 95% CI: 0.04-0.49). Speech functional outcomes showed no significant differences.

conclusionPTL improves survival and swallowing function with fewer complications, making it a preferred upfront treatment. STL remains essential for managing failures. Early identification of high-risk patients may improve clinical decision-making, optimizing survival and functional outcomes.

Indexed as

Laryngeal NeoplasmsLaryngectomyLarynxSalvage TherapyHumansPostoperative ComplicationsSurvival RateLaryngeal cancerPharyngocutaneous fistulaPrimary total laryngectomySalvage total laryngectomyTracheoesophageal voice prosthesis

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.