title: High-Grade Neuroendocrine Carcinoma of the Larynx: The Mayo Clinic Experience.
abstract: OBJECTIVE
  To report a single institutional series of high-grade neuroendocrine carcinoma of the larynx (NCL), a very rare yet aggressive tumor. To review the management of NCL, including discussion of clinical behavior, treatment outcome, and prognosis.
  
  
  METHODS
  A retrospective chart review of high-grade laryngeal neuroendocrine carcinomas at a single institution, including small- and large-cell neuroendocrine carcinomas. A total of 8 patients with high-grade NCL treated at our institution from 1992 to 2014 were identified.
  
  
  RESULTS
  The median age at diagnosis was 65.5 years (range, 43-80). Five patients were male. Two patients had a known smoking history. Primary tumor location was supraglottic in 7 patients and glottic in 1 patient. Primary treatment consisted of surgery alone (3 patients), radiotherapy alone (1 patient), combination of chemotherapy and radiotherapy (1 patient), and surgery followed by postoperative chemoradiotherapy (3 patients). Locoregional recurrence followed by distant metastasis occurred in 6 patients. Median overall survival was 44.0 months (95% CI, 3-62.0).
  
  
  CONCLUSIONS
  High-grade NCL is a rare diagnosis. Compared to well- and moderately differentiated NCL, high-grade NCL has a far more aggressive clinical course and associated with a worse prognosis. To our knowledge, this is the largest series of patients with high-grade NCL treated at a single institution. Prompt diagnosis and multimodality therapy including elective neck dissection may improve survival.
authors.affiliation: Mayo Clinic, Otolaryngology, Head & Neck Surgery, Phoenix, Arizona, USA.
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Deep
authors.affiliation: Mayo Clinic, Otolaryngology, Head & Neck Surgery, Rochester, Minnesota, USA.
authors.forename: Dale C
authors.initials: DC
authors.lastname: Ekbom
authors.affiliation: Mayo Clinic, Otolaryngology, Head & Neck Surgery, Phoenix, Arizona, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Hinni
authors.affiliation: Mayo Clinic, Laboratory Medicine and Pathology, Phoenix, Arizona, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Zarka
authors.affiliation: Mayo Clinic, Radiation Oncology, Phoenix, Arizona, USA patel.samir@mayo.edu.
authors.forename: Samir H
authors.initials: SH
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D005260:Female; D005931:Glottis / Q000473:pathology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures; D011878:Radiotherapy; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents
keywords: head and neck cancer; high-grade neuroendocrine carcinoma of the larynx; large cell; small cell