Long-term Efficacy And Laryngeal Function Preservation Rate Of Surgical And Non Surgical Treatment For Advanced Hypopharyngeal Carcinoma Based On Meta-analysis

Objective:To systematically evaluate the effectiveness and safety of surgical treatment and non-surgical treatment for advanced hypopharyngeal cancer,and provide reference for clinical treatment.Methods:China Biomedical Literature Service system(Sino Med),Wanfang,China Journal full-text Database(CNKI),Chinese Sci-tech Journals Database(VIP),Pub Med,Springerlink,Webofscience and other databases published from 2000 to 2023 were used to search the cohort studies on the efficacy and safety of surgery and radiotherapy,chemotherapy,simultaneous radiotherapy and chemotherapy in the treatment of advanced hypopharyngeal cancer,without restriction on region,sample size,race,etc.After screening the literatures that meet the requirements and extracting the required data,the quality of the literature was evaluated by Coc HRane bias risk assessment tool,and the results were analyzed by meta using Review Manager5.4 software.the evaluation indicators mainly include overall survival rate,incidence of complications,preservation rate of laryngeal function and local recurrence rate.Results:After searching various databases,the literatures were screened carefully and 16 articles were included.The study included 2164 cases,of which 981 were operative and1183 were non-operative.The results showed that the 5-year overall survival rate was OR=1.74,95%CI1.21～2.50,Z=2.98,P=0.003,which indicated that the 5-year overall survival rate in the operation group was higher than that in the non-operation group,and the 3-year overall survival rate in the operation group was higher than that in the non-operation group,indicating that the combined effect of the operation group and the non-operation group should be statistically significant.The preservation rate of laryngeal function: OR=0.24,95%CI0.09～0.64,Z=2.86,P=0.004,indicating that the preservation rate of laryngeal function in the operation group was lower than that in the non-operation group,and the occurrence of complications: OR=1,95%CI0.35～2.83,Z=0.01,P=1,indicating that there was no significant difference in the occurrence of complications between the operation group and the non-operation group.Local recurrence rate:OR=0.47,95%CI0.37～0.60,Z=6.01,P <0.001,indicating that the local recurrence rate in the operation group is lower than that in the non-operation group.Conclusions:Surgical treatment can improve the 3-year and 5-year overall survival rate and reduce the local recurrence rate of patients with advanced hypopharyngeal carcinoma.The long-term effect of surgical treatment is better than that of non-operative treatment,but the preservation rate of laryngeal function of surgical treatment is lower than that of non-operative treatment.Compared with non-operative comprehensive treatment,surgery-based treatment can achieve better long-term effect,but the preservation of laryngeal function is poor.