Management Of The Clinically Negative Neck (NO) Of Supraglottic Laryngeal Carcinoma: Meta-analysis

Objective: To assess the most efficacy of the management for patients with supraglottic laryngeal carcinoma (SGLC) and clinically negative neck (cN0).Methods: According to the Cochrane handbook , the search strategy were developed.The CBM,Cochrane library,Medline(Ovid),Embase,and the journals were searched.Trials were collected and evaluated. Meta-analysis was processed by RevMan 4.3.Date including overall survival rate,disease free survival rate, disease-specific survival rate,recurrence rate and metastasis rate,these was pulled using fixed effect model according to their homogeneity or heterogeneity.And sensitivity analysis would be taken if considered appropriate.Results: 6 studies were enrolled in meta analysis.All studies included in the systematic review were retrospective (n=892 patients). The survival (overall, disease-specific, disease free) and the neck recurrence of the patients with N0 supraglottic cancer were not significantly different between patients in the neck dissection treatment group and the neck radiotherapy, combined therapy and'wait and see'group.The p value all greater than 0.05.These finding suggest there were no significant difference in these treatments.Conclusions: There were no significant difference in the management of cN0 of SGLC(neck dissection treatment and neck radiotherapy, combined therapy and'wait and see'group), Which suggested that"wait and see"did not affect the efficacy and could reduce injury to patients, through strictly preoperative evaluation and clinical diagnosis.But,all the studies were prospective lack of enough patients scale,there were the possible of the selection bias and sensitivity bias.The systematic review need for further well-designed and more high quality randomized controlled trials to answers to the debatable issue of the management of cN0 of SGLC..