Long-term outcomes and prognosis of neuroendocrine neoplasms of the head and neck: a cohort from a single institution

TL;DR

This study examines the long-term outcomes and treatment effectiveness for a rare head and neck cancer called neuroendocrine neoplasm.

Contribution

The study provides new insights into the role of radiotherapy and systemic treatments in managing this rare cancer.

Findings

Radiotherapy improved local-regional control in patients with neuroendocrine neoplasms of the head and neck.

Combining local and systemic treatments appears to be the optimal regimen for better survival outcomes.

Distant metastasis was the main pattern of treatment failure in 47.3% of patients.

Abstract

Neuroendocrine neoplasm is a rare cancer of head and neck. This study aimed to evaluate clinical features, treatment outcomes, and prognostic factors of neuroendocrine neoplasm of head and neck treated at a single institution.

Between Nov 2000 and Nov 2021, ninety-three patients diagnosed with neuroendocrine neoplasms of head and neck treated at our institution were reviewed retrospectively. The initial treatments included chemotherapy (induction, adjuvant, or concurrent) combined with radiotherapy in 40 patients (C + RT group), surgery followed by post-operative RT in 34 (S + RT group), and surgery plus salvage therapy in 19 patients (S + Sa group).

The median follow-up time was 64.5 months. 5-year overall survival rate (OS), progression-free survival rate (PFS), loco-regional relapse-free survival free rate (LRRFS) and distant metastasis-free survival rate (DMFS) were 64.5%, 51.6%, 66.6%, and 62.1%, respectively. For stage I–II, the 5-year LRRFS for patients’ treatment regimen with or without radiotherapy (C + RT and S + RT groups versus S + Sa group) was 75.0% versus 12.7% (p = 0.015) while for stage III–IV, the 5-year LRRFS was 77.8% versus 50.0% (p = 0.006). The 5-year DMFS values for patients with or without systemic therapy (C + RT group versus S + RT or S + Sa) were 71.2% and 51.5% (p = 0.075). 44 patients (47.3%) experienced treatment failure and distant metastasis was the main failure pattern.

Radiotherapy improved local–regional control and played an important role in the management of HNNENs. The optimal treatment regimen for HNNENs remains the combination of local and systemic treatments.

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