人乳头瘤病毒（HPV）感染或吸烟对口咽部高级神经内分泌癌（HG-NEC）的预后影响尚未确定。本研究回顾性研究收集1997年至2020年在MD Anderson癌症中心接受治疗的口咽部HG-NEC患者以及先前报道的已知p16和HPV状态的口咽部HG-NEC患者。采用Kaplan-Meier方法评估生存率，并使用log-rank测试和Cox比例风险模型评估生存差异。本研究共纳入30名患者；大多数患者有重度吸烟史（≥10包年，52％），有局部区域疾病（III-IVB期，77％），肿瘤为p16阳性（92％）。测试的标本中65％（23/15）为HPV阳性。经过治愈意图治疗的24名患者中，诱导化疗和确切放疗的客观反应率分别为90％（9/10）和81％（17/21）。随访期间，54％（13/24）的患者复发，大多数患者（11/13）在远处发生复发。中位总生存期（OS）为46个月（95％CI，14.3-NA）。HPV感染状态（HR 0.73，P = 0.6）或吸烟（HR 1.16，P 0.8）与OS无关。在63名进行文献复查后已知HPV状态的患者中（19名为HPV-和44名为HPV +），HPV状态仍然与OS无关（P = 0.92）。这是迄今为止口咽部HG-NEC最大的回顾性队列。经过治愈性治疗后的远处复发率很高，因此表明多模态治疗，包括系统性治疗，可能有益于局部晚期患者。HPV感染对生存结局无影响，因此不应导致对此组织学疗法的降强度。版权所有©2023 Elsevier Ltd.。保留所有权利。

The prognostic impact of human papillomavirus (HPV) infection or smoking on oropharyngeal high-grade neuroendocrine carcinoma (HG-NEC) is not established.Retrospective study with patients with oropharyngeal HG-NEC seen at MD Anderson Cancer Center from 1997 to 2020, and previously reported patients with oropharyngeal HG-NEC and known p16 and HPV status from the literature review. Survival was estimated with the Kaplan-Meier method, and survival differences assessed with the log-rank test and Cox proportional hazards models.Thirty patients were included; most had a heavy (≥10 pack-years) smoking history (52%), locoregional disease (stage III-IVB; 77%), and p16-positive tumor (92%). HPV was positive in 65% of tested samples (15/23). Of 24 patients treated with curative intent, the objective response rates was 90% (9/10) and 81% (17/21), respectively, for induction chemotherapy and definitive radiotherapy. During follow-up, 54% (13/24) recurred, mostly (11/13) at distant sites. Median overall survival (OS) was 46 months (95% CI, 14.3 - NA). OS was not associated with HPV status (HR 0.73, P = 0.6) or smoking (HR 1.16, P = 0.8). Among 63 patients with known HPV status after the literature review (19 HPV- and 44 HPV + ), HPV status remained unassociated with OS (P = 0.92).This is the largest retrospective cohort of oropharyngeal HG-NEC. Distant recurrence rate after curative treatment was high, suggesting that multimodality treatment including systemic therapy may benefit patients with locally advanced disease. HPV infection did not affect survival outcomes, therefore should not lead to therapy de-intensification for this histology.Copyright © 2023 Elsevier Ltd. All rights reserved.