Temporal Trends in Incidence and Prognostic Factors of Head and Neck Neuroendocrine Tumors: A Population-Based Analysis, 1975 – 2017

Background: Head and neck neuroendocrine tumors (HNNETs) are rare, heterogeneous and aggressive, with limited epidemiological and prognostic data. This study aimed to evaluate temporal trends in incidence and examine prognostic factors using population-based data. Methods: A total of 1,090 cases diagnosed from 1975–2017 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Temporal incidence trends were analyzed, and overall survival (OS) was examined using Kaplan-Meier analysis and Cox proportional hazards models. Results: Since 1975, the number of HNNET cases has consistently increased, notably outpacing the general trend in head and neck tumors, which is predominantly attributed to regional stage, poorly differentiated tumors. The median OS was 21 months. Multivariate analysis identified older age, advanced stage, higher grade, and primary site as independent negative prognostic factors. Surgery, chemotherapy, and radiotherapy significantly improved survival, with multimodality treatments showing the most substantial benefit. Conclusions: HNNET incidence has risen over recent decades, mostly as advanced-stage, high-grade cases. Prognosis significantly depends on age, stage, grade, primary site, and treatment strategy. Multimodality therapy offers notable survival advantages, emphasizing the need for early detection and tailored therapeutic strategies.