Prognostic Impact of Anterior Commissure Involvement on Treatment Failure in Early-Stage Glottic Carcinoma Treated With Definitive Radiotherapy: A Univariate and Multivariate Meta-Analysis.

This study represents the first application of both univariate and multivariate meta-analysis to clarify the prognostic role of ACI in early-stage glottic carcinoma treated with definitive RT. While univariate analysis suggested ACI increased recurrence risk, this effect was not confirmed in MVMA-MF, indicating the univariate findings may be confounded by correlation with other factors, particularly T substage. MVMA-MF approach accounted for heterogeneity, collinearity and incomplete reporting, providing more robust evidence. This work underscores the value of advanced multivariate methods in oncology meta-analysis and provides the strongest evidence to date that ACI should not be regarded as a fundamental prognostic criterion in early-stage glottic carcinoma.