Survival Outcomes of Head and Neck Neuroendocrine Carcinoma: A Systematic Review

Background This systematic review investigated pathological, oncological, and survival outcomes of Head and neck neuroendocrine carcinoma (HNNEC). Methods Three independent investigators conducted a PRISMA‐compliant literature search. Primary outcomes included tumor stage, overall survival (OS), disease‐free survival, recurrence, metastasis, and therapeutic strategies. Results The most common locations were the larynx ( n = 1041), sinonasal tract ( n = 917), and oropharynx ( n = 366), mostly cT2/cT4 and cN0/cN2. Small‐cell carcinoma predominated ( n = 2334). Laryngeal tumors were preferentially treated by surgery plus radiotherapy, sinonasal/nasopharyngeal tumors by chemoradiotherapy, and salivary tumors by surgery with adjuvant therapy. Surgical cohorts achieved 5‐year OS of 33.0%–73.9%, and multimodal CRT‐plus‐surgery 57.2%–61.0%. Laryngeal and mucosal tumors had more favorable outcomes than sinonasal/salivary localizations; well/moderately‐differentiated carcinoids outperformed poorly‐differentiated and small‐cell variants (median OS < 24 months). Conclusion HNNEC survival strongly depends on histology, site, and treatment modality. Substantial therapeutic heterogeneity reflects the lack of guidelines, highlighting the need for standardized, histology‐ and site‐specific management recommendations.