T1-T2 squamous cell carcinoma of the uvula: a little big enemy.

OBJECTIVE No specific epidemiology data are available for carcinoma of the uvula. This study aims to analyze the epidemiological characteristics and treatment outcomes of carcinoma of the uvula at the authors' institution. STUDY DESIGN Case series with chart review. SETTING Service of ENT-Head and Neck Surgery, University Hospital Complex of Santiago de Compostela (CHUS), Spain. SUBJECTS AND METHODS Retrospective epidemiological study of 21 male patients, mean age 57.52 years, diagnosed with squamous cell carcinoma of the uvula in the CHUS between January 1990 and June 2009. RESULTS Most patients presented with odynophagia and exophytic lesions microscopically consistent with moderately differentiated squamous cell carcinoma. Despite the size of the lesions (T1 and T2), more than half of the patients had lymph node metastases at diagnosis. More than 90.0% of patients with lesions larger than 1 cm presented with lymph node metastases. Although more than 70.0% of patients underwent a neck dissection in the first year after diagnosis, only 25.0% were free of metastatic disease. Recurrences occurred at a mean of 14 months from baseline in more than 50.0% of cases. Of the patients, 52.4% died, with a median survival of 38.15 months after diagnosis. The overall 5-year survival was 39.0%. According to tumor size, 5-year survival was 53.0% for T1 and 27.0% for T2. CONCLUSION According to the data, clinical features of carcinoma of the uvula correspond with aggressive tumors, with rapid onset and a major negative impact regardless of tumor size at diagnosis. Early stage patients benefit significantly from surgical treatments with neck dissections.