Does sex influence the prognosis of laryngeal cancer? A systematic review and a meta-analysis

Laryngeal cancer (LC) represents the tumor with the highest male-to-female sex ratio, yet the prognostic significance of sex remains uncertain. This study aimed to assess whether sex serves as an independent predictor of tumor control and survival in patients with laryngeal cancer. A systematic review and a meta-analysis of the literature was performed by querying the PubMed, Scopus, and Google Scholar databases. Outcome measures were overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Cumulative hazard ratios (HRs) with 95 % CI are presented for the reported outcomes. QUIPS tool was used for evaluating biases. Out of a total of 16,592 retrieved articles, a total of 19 articles were included for quantitative analyses. A total of 1195 women affected by LC were analyzed, and compared to 7966 male patients: pooled analysis for survival revealed no significant sex-based differences (OS: HR = 0.786, 95 % CI: 0.590–1.047; DFS: HR = 0.465, 95 % CI 0.150–1.437; DSS: HR = 0.152, 95 % CI 0.01–12.82). All the included studies showed a low to moderate overall risk of bias. This meta-analysis suggests that sex does not represent a significant independent prognostic factor for patients affected by laryngeal cancer.