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Updated: Aug 5, 2026
A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Neuroendocrine Carcinoma of the Head and Neck: A Two-Decade Institutional Experience
Micah K Harris1, Katie M Carlson1,2, Nathan Lu1
1Department of Otolaryngology-Head and Neck Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA.
Objectives:
Primary neuroendocrine carcinoma (NEC) of the head and neck is rare (< 1% of cases) and aggressive, with poorly defined management strategies. This study evaluated clinical characteristics, treatment patterns, and survival outcomes in a single-institution cohort, identifying factors associated with improved survival.
Methods:
A retrospective review was conducted of patients with head and neck NEC treated at a tertiary center. Variables associated with 3-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were assessed using Cox regression and Kaplan-Meier curve analyses.
Results:
Sixty-nine patients (59.4% male, 95.7% White) were included. The most common subsites were sinonasal (36.2%) and laryngeal (30.4%). Most tumors were poorly differentiated (73.9%), and 50.7% were T category 3-4. Surgical resection was performed in 68.1% and primary radiotherapy or chemoradiotherapy in 20.3% of patients. Overall 3-year OS and RFS were 55.5% and 56.1%, respectively. On multivariable analysis, surgery remained associated with improved 3-year OS (adjusted hazard ratio [aHR]: 0.21, 95% CI: 0.06-0.66, p = 0.007) and DSS (aHR: 0.33, 95% CI: 0.11-0.99, p = 0.050) when controlling for tumor stage, histologic differentiation, tumor site, and age at diagnosis. Chemotherapy and radiotherapy were not associated with survival.
Conclusions:
Head and neck NEC carries a poor prognosis. Undergoing surgical resection was strongly associated with improved 3-year OS and DSS in our cohort, highlighting its importance when feasible. Multicenter collaboration and prospective studies are warranted to refine optimal treatment strategies for this rare and challenging malignancy.
