Matsuo Mioko, Tsuchihashi Kenji, Miyamoto Yusuke, Hashimoto Kazuki, Kogo Ryunosuke, Komune Noritaka, Sato Masanobu, Masuda Shogo, Nakagawa Takashi
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Hematology, Oncology and Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Cancer Diagn Progn. 2025 Jun 30;5(4):469-477. doi: 10.21873/cdp.10460. eCollection 2025 Jul-Aug.
BACKGROUND/AIM: Neuroendocrine neoplasms (NEN) of the head and neck (HN) region are rare, with limited reported cases. NENs are classified into neuroendocrine tumors (NET) grades G1, G2, and G3, and neuroendocrine carcinomas (NECs), with varying treatment strategies. This study investigated patient outcomes of HN-NENs and proposed a treatment algorithm based on pathological classification.
This retrospective study analyzed 24 HN-NEN cases treated at Kyushu University Hospital (2007-2023). Tumors were classified using the 2022 WHO criteria, and overall survival rates were evaluated using the Kaplan-Meier method.
Among the 24 patients, 29% had NETs and 71% had NECs. The most common primary sites were the sinonasal cavity (42%) and larynx (29%). Seven-year survival rates were 100% for NET G1 and G2, 50% for NET G3, and 43% for NEC. Two NET cases treated with somatostatin analogs (SSA) and radionuclide therapy (PRRT) showed tumor reduction.
Prognosis of HN-NENs varies significantly by pathological grade. While NET G1 and G2 showed favorable outcomes, NET G3 and NEC had poorer survival. SSA and PRRT may be effective options for selected HN-NETs. A preliminary treatment algorithm is proposed to guide management, warranting validation in larger studies.
背景/目的：头颈部（HN）区域的神经内分泌肿瘤（NEN）较为罕见，报道的病例有限。NEN分为神经内分泌瘤（NET）G1、G2和G3级以及神经内分泌癌（NEC），治疗策略各不相同。本研究调查了HN-NEN患者的预后，并根据病理分类提出了一种治疗算法。
这项回顾性研究分析了九州大学医院（2007 - 2023年）治疗的24例HN-NEN病例。使用2022年世界卫生组织标准对肿瘤进行分类，并采用Kaplan-Meier方法评估总生存率。
24例患者中，29%为NET，71%为NEC。最常见的原发部位是鼻腔鼻窦（42%）和喉（29%）。NET G1和G2的7年生存率为100%，NET G3为50%，NEC为43%。2例接受生长抑素类似物（SSA）和放射性核素治疗（PRRT）的NET病例显示肿瘤缩小。
HN-NEN的预后因病理分级而异。NET G1和G2显示出良好的预后，而NET G3和NEC的生存率较差。SSA和PRRT可能是部分HN-NET的有效治疗选择。提出了一种初步的治疗算法以指导管理，有待在更大规模的研究中进行验证。
