Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/130217
Type: Thesis
Title: Factors affecting surgical mortality of oral squamous cell carcinoma resection
Author: Ong, Yi Long Roy
Issue Date: 2021
School/Discipline: Adelaide Medical School
Abstract: Survival rates for oral cancer showed minimal improvement in six decades, improving surgical outcomes could be an avenue to reduce mortality. This thesis seeks to identify the causes of surgical mortalities, evaluate the factors involved and determine if there are any modifiable risks that could be targeted to reduce the mortality in the post-operative period. The systematic review found that there is a paucity of existing knowledge on the factors affecting surgical mortality of oral squamous cell carcinoma. While there were two studies included, only one had detailed characteristics on the patients who died after the operation. A population level study illustrated that factors such as advanced age, an increased Charlson Comorbidity Index score, T classification had statistical significance in increasing the risk of surgical mortality, and the risk increases if these factors were combined. Analysis of data from the Australian and New Zealand Audit of Surgical Mortality (ANZASM) found that many of the preventable deaths were related to poor patient selection. The surgeons and assessors felt that these patients had very high pre-operative risk due to various factors such as advanced age, co-existing systemic illnesses such are cardiac and respiratory conditions and advanced malignancy. Changes could be made to ANZASM to improve the results for analysis. Further population analysis and establishment of an externally validated model to assess risk stratification will allow surgeons to make better decisions around patient selection and reduce avoidable surgical mortalities.
Advisor: Maddern, Guy
Sambrook, Paul
Dissertation Note: Thesis (MPhil) -- University of Adelaide, Adelaide Medical School, 2020
Keywords: oral cancer
surgical mortality
squamous cell carcinoma
Provenance: This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals
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