UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

The prognosis of oral epithelial dysplasia and oral squamous cell carcinoma in individuals with oral lichen planus: a single-centre observational study and a pioneer preliminary exploration of UK national Electronic Health Records

Pimolbutr, Kununya; (2021) The prognosis of oral epithelial dysplasia and oral squamous cell carcinoma in individuals with oral lichen planus: a single-centre observational study and a pioneer preliminary exploration of UK national Electronic Health Records. Doctoral thesis (Ph.D), UCL (University College London).

[thumbnail of Kununya_Thesis_Correction_Final.pdf] Text
Kununya_Thesis_Correction_Final.pdf
Access restricted to UCL open access staff until 1 July 2022.

Download (9MB)

Abstract

Head and neck squamous cell carcinoma (HNSCC) is a significant public health problem worldwide due to its high mortality and morbidity. A notable proportion of HNSCC, particularly oral squamous cell carcinoma (OSCC), is preceded by several long-standing chronic oral mucosal diseases including oral lichen planus (OLP). However, it remains largely unknown regarding the impact of a pre-existing OLP upon the prognosis and behaviour of OSCC and its precursor, oral epithelial dysplasia (OED). Therefore, this PhD thesis has sought to determine the influence of OLP on the long-term behaviour and prognosis of oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC) using data from a single UK tertiary care centre. Additionally, this thesis has made the first steps towards providing understanding of the epidemiology of HNSCC in a representative sample with common chronic oral mucosal conditions including oral lichen planus, oral submucous fibrosis, leukoplakia and periodontal diseases of the UK population. A retrospective cohort study of 299 patients with OED revealed that individuals with OED arising on a background of OLP appeared to be at higher risk of developing new primary OEDs up to 3 years (in the early years) after the first diagnosis of OED compared to those without OLP. However, the risk of malignant progression was similar between the two groups. This thesis built on these findings by investigating the impact of OLP in determining the long-term behaviour and prognosis of OSCC using a retrospective cohort study of 285 patients with OSCC. The results indicated that patients with OSCC-associated OLP were more likely to develop multiple and multifocal new primary dysplastic and OSCC events following their first oral malignancy. Despite this, there seems to be no significant association between OLP and mortality. In order to reveal more about the relationship between long-standing oral mucosal conditions and HNSCC using national-scale data, this thesis went beyond single data sources. This project provides a detailed method for appropriate data handling and curation of a linked national database of a UK population (the CALIBER platform). This allowed the development and validation of a reliable phenotype algorithm to identify patients with HNSCC from this data platform. Taken together, these findings advance understanding of the impact of OLP on the behaviour and prognosis of OED and OSCC. In addition, the HSNCC phenotype algorithm developed here represents an important step towards understanding the association between common chronic oral mucosal conditions and HNSCC in the UK.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: The prognosis of oral epithelial dysplasia and oral squamous cell carcinoma in individuals with oral lichen planus: a single-centre observational study and a pioneer preliminary exploration of UK national Electronic Health Records
Event: UCL (University College London)
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10129180
Downloads since deposit
3Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item