Featured Publications
Guideline - Adherence in advanced stage head and neck cancer is associated with improved survival – A National study
Cohen O, Brauer PR, Judson BL, Burtness BA, Earles J, Mehra S. Guideline - Adherence in advanced stage head and neck cancer is associated with improved survival – A National study. Oral Oncology 2021, 125: 105694. PMID: 34971883, DOI: 10.1016/j.oraloncology.2021.105694.Peer-Reviewed Original ResearchConceptsOverall survivalNCCN guidelinesGuideline adherenceAdherence ratesNeck cancerAdvanced stage HNCGuideline adherence rateOverall stage IIINational Cancer DatabaseDecreased overall survivalAdvanced-stage headPrevalence of guidelinesComorbidity scoreAdherent patientsAdvanced headClinical stagingImproved survivalGuideline awarenessHNC patientsBlack raceInsurance statusNational cohortCancer DatabaseRisk factorsFemale genderTreatment Delays in Primarily Resected Oropharyngeal Squamous Cell Carcinoma: National Benchmarks and Survival Associations
Morse E, Judson B, Husain Z, Burtness B, Yarbrough WG, Sasaki C, Cheraghlou S, Mehra S. Treatment Delays in Primarily Resected Oropharyngeal Squamous Cell Carcinoma: National Benchmarks and Survival Associations. Otolaryngology 2018, 159: 987-997. PMID: 30060700, DOI: 10.1177/0194599818779052.Peer-Reviewed Original ResearchHPV-positive patientsRadiation treatment durationTotal treatment packageOverall survivalTreatment initiationTreatment durationEnd intervalOropharyngeal cancerTreatment delayTreatment packageOropharyngeal squamous cell carcinomaCox proportional hazards regressionMultivariable logistic regression analysisRadiation treatmentRetrospective cross-sectional analysisNational Cancer DatabaseProportional hazards regressionSquamous cell carcinomaDuration of diagnosisLogistic regression analysisNational benchmarksCross-sectional analysisMedian durationOverall cohortHazards regression
2024
The Impact of Four Smoking Metrics on Survival After Diagnosis with HPV+ Oropharyngeal Cancer
Wilkins S, Shah R, Safranek C, Shah H, Mehra S. The Impact of Four Smoking Metrics on Survival After Diagnosis with HPV+ Oropharyngeal Cancer. The Laryngoscope 2024, 134: 3158-3164. PMID: 38294283, DOI: 10.1002/lary.31319.Peer-Reviewed Original ResearchOropharyngeal squamous cell carcinomaRecurrence-free survivalHPV+ oropharyngeal squamous cell carcinomaOverall survivalPack-yearsTobacco useRetrospective review of patientsImpact overall survivalReview of patientsSquamous cell carcinomaSmoking metricsInferior OSImpact of tobacco useMetastatic diseaseImpact of smokingPrognostic significanceRetrospective reviewCell carcinomaSmoking historyUnivariate analysisNever-smokersMultivariate analysisSmoking statusPatientsInclusion criteria
2022
Human Immunodeficiency Virus Is Associated With Poor Overall Survival Among Patients With Head and Neck Cancer
Salahuddin S, Cohen O, Wu M, Irizarry J, Vega T, Gan G, Deng Y, Isaeva N, Prasad M, Schalper K, Mehra S, Yarbrough W, Emu B. Human Immunodeficiency Virus Is Associated With Poor Overall Survival Among Patients With Head and Neck Cancer. Clinical Infectious Diseases 2022, 76: 1449-1458. PMID: 36520995, PMCID: PMC10319962, DOI: 10.1093/cid/ciac924.Peer-Reviewed Original ResearchConceptsOverall survivalIndependent predictorsHNSCC patientsWorse prognosisOropharyngeal tumorsCox proportional hazards regression modelMultivariate analysisHPV-positive oropharyngeal tumorsNeck squamous cell cancerProportional hazards regression modelsLower median overall survivalAcademic hospital centerNon-HIV populationMedian overall survivalPredictors of survivalSquamous cell cancerHuman immunodeficiency virusPoor clinical outcomeExpression of CD4Poor overall survivalHazards regression modelsRace/ethnicityCD8 infiltrationHazard ratioClinicopathologic characteristics
2021
Extranodal Head and Neck Mantle Cell Lymphoma: Characteristics, Treatment, and Survival
Breen CT, Chao J, Mehra S, Kohli N. Extranodal Head and Neck Mantle Cell Lymphoma: Characteristics, Treatment, and Survival. Annals Of Otology Rhinology & Laryngology 2021, 131: 412-419. PMID: 34137303, DOI: 10.1177/00034894211025171.Peer-Reviewed Original ResearchConceptsMantle cell lymphomaExtranodal mantle cell lymphomaCumulative incidenceOverall survivalCell lymphomaEnd Results 18 registriesStage IV diseaseEarly-stage diseaseCause-specific hazards modelLate-stage diseaseProportion of casesSignificant differencesExtranodal headChemoradiation therapyCommon subsiteDisease characteristicsCommon siteAnatomic sitesPrimary headRadiation therapyCommon treatmentOral cavityHazards modelStage IIIStage IProlonged inpatient stay after upfront total laryngectomy is associated with overall survival
Jacobs D, Kafle S, Earles J, Rahmati R, Mehra S, Judson BL. Prolonged inpatient stay after upfront total laryngectomy is associated with overall survival. Laryngoscope Investigative Otolaryngology 2021, 6: 94-102. PMID: 33614936, PMCID: PMC7883619, DOI: 10.1002/lio2.441.Peer-Reviewed Original ResearchNational Cancer DatabaseTotal laryngectomyOverall survivalInpatient LOSMultivariable analysisCharlson-Deyo comorbidity scoreLong-term overall survivalPostoperative long-term mortalityMultivariable binary logistic regressionNinety-day mortalityUpfront total laryngectomyLong-term mortalityDays of diagnosisKaplan-Meier analysisBinary logistic regressionProlonged LOSComorbidity scoreWorse OSPatient ageCox regressionInpatient stayVolume centersClose surveillanceFemale sexInpatient length
2020
Revisiting the Radiation Therapy Oncology Group 1221 Hypothesis: Treatment for Stage III/IV HPV-Negative Oropharyngeal Cancer
Jacobs D, Torabi SJ, Park HS, Rahmati R, Young MR, Mehra S, Judson BL. Revisiting the Radiation Therapy Oncology Group 1221 Hypothesis: Treatment for Stage III/IV HPV-Negative Oropharyngeal Cancer. Otolaryngology 2020, 164: 1240-1248. PMID: 33198564, DOI: 10.1177/0194599820969613.Peer-Reviewed Original ResearchConceptsNational Cancer DatabaseHPV-negative oropharyngeal cancersChemoradiation therapyOverall survivalCancer DatabaseOropharyngeal cancerHPV-negative oropharyngeal squamous cell carcinomaLarge national cancer databaseNeck cancer-specific survivalOropharyngeal squamous cell carcinomaCox proportional hazards regressionKaplan-Meier survival analysisCancer-specific survivalImproved overall survivalMultivariable Cox regressionRetrospective cohort studyAdjuvant chemoradiation therapyUse of surgeryEnd Results ProgramProportional hazards regressionSquamous cell carcinomaSEER cohortAdjuvant therapyCohort studySEER databaseThe epidemiology, surgical management, and impact of margins in skull and mandibular osseous‐site tumors
Torabi SJ, Bourdillon A, Salehi PP, Kafle S, Mehra S, Rahmati R, Judson BL. The epidemiology, surgical management, and impact of margins in skull and mandibular osseous‐site tumors. Head & Neck 2020, 42: 3352-3363. PMID: 32743892, DOI: 10.1002/hed.26389.Peer-Reviewed Original ResearchConceptsOverall survivalPositive marginsImproved overall survivalNational Cancer DatabaseEffect of surgeryInherent selection biasSurgical managementCox regressionCancer DatabaseTreatment outcomesCartilage tumorsMultivariate analysisSurgeryTumorsOsteosarcomaEpidemiologySelection biasImpact of marginsTreatmentDescriptive analysisCohort
2019
1149P Pathologic staging changes in oral cavity squamous cell carcinoma: Stage migration and implications for adjuvant treatment
Husain Z, Lee N, Eskander A, Park H, mehra S, Burtness B. 1149P Pathologic staging changes in oral cavity squamous cell carcinoma: Stage migration and implications for adjuvant treatment. Annals Of Oncology 2019, 30: v466. DOI: 10.1093/annonc/mdz252.041.Peer-Reviewed Original ResearchOral cavity squamous cell carcinomaPathologic extranodal extensionDepth of invasionSquamous cell carcinomaPT3N0 patientsOverall survivalStage migrationCell carcinomaStaging systemAJCC-8 staging systemFive-year overall survivalNational InstitutePathologic tumor classificationNational Cancer DatabaseAmerican Joint CommitteeRisk of deathNew staging systemBristol-Myers SquibbPStage IVBUpstaged tumorsDefinitive surgeryPostoperative radiotherapyPT3 tumorsAdjuvant treatmentExtranodal extension1127P Brachytherapy and non-cancer mortality in patients with oral cavity and oropharynx SCCs
Yu J, Tsay C, Sasaki C, Son Y, Decker R, Mehra S, Burtness B. 1127P Brachytherapy and non-cancer mortality in patients with oral cavity and oropharynx SCCs. Annals Of Oncology 2019, 30: v457. DOI: 10.1093/annonc/mdz252.019.Peer-Reviewed Original ResearchNon-cancer mortalityExternal beam radiationOverall survivalCancer mortalityOral cavityOropharyngeal squamous cell cancerBrachytherapy-treated patientsGenentech/RocheImpact of brachytherapyReceipt of brachytherapySecond primary cancerEffect of comorbiditySquamous cell cancerProportional hazards regressionSingle-institution studyHigher cancer mortalityBeam radiationElectronic medical recordsGlaxo Smith KlineBristol-Myers SquibbEligible patientsOropharynx SCCHPV statusPrimary malignancySecondary outcomesIs robotic surgery an option for early T‐stage laryngeal cancer? Early nationwide results
Hanna J, Brauer PR, Morse E, Judson B, Mehra S. Is robotic surgery an option for early T‐stage laryngeal cancer? Early nationwide results. The Laryngoscope 2019, 130: 1195-1201. PMID: 31233223, DOI: 10.1002/lary.28144.Peer-Reviewed Original ResearchConceptsTransoral robotic surgeryTransoral laser microsurgeryAdjuvant radiationOpen surgerySupraglottic patientsOverall survivalCox regressionMargin statusMultivariable analysisSurgical approachLaryngeal cancerLaryngeal squamous cell carcinoma patientsSquamous cell carcinoma patientsEarly-stage laryngeal cancerRobotic surgeryMultivariable Cox regressionNational Cancer DatabaseCell carcinoma patientsRetrospective database analysisViable treatment optionTORS patientsPartial surgeryMultivariable logisticCarcinoma patientsNegative marginsPositive Surgical Margins in Submandibular Malignancies: Facility and Practice Variation
Benchetrit L, Morse E, Judson BL, Mehra S. Positive Surgical Margins in Submandibular Malignancies: Facility and Practice Variation. Otolaryngology 2019, 161: 620-628. PMID: 31159649, DOI: 10.1177/0194599819852094.Peer-Reviewed Original ResearchConceptsPositive margin ratePositive surgical marginsPositive marginsOverall survivalMargin rateSurgical resectionSurgical marginsSubmandibular carcinomaCox proportional hazards regressionMultivariable logistic regression analysisCancer-accredited hospitalsPreoperative diagnostic biopsiesNational Cancer DatabasePrimary surgical resectionAdvanced T stageKaplan-Meier curvesProportional hazards regressionLogistic regression analysisQuality of careCarcinoma histologyRetrospective cohortMargin statusPreoperative biopsyT stageHazards regressionPathologic staging changes in oral cavity squamous cell carcinoma: Stage migration and implications for adjuvant treatment
Lee NCJ, Eskander A, Park HS, Mehra S, Burtness BA, Husain Z. Pathologic staging changes in oral cavity squamous cell carcinoma: Stage migration and implications for adjuvant treatment. Cancer 2019, 125: 2975-2983. PMID: 31090934, DOI: 10.1002/cncr.32161.Peer-Reviewed Original ResearchConceptsOral cavity squamous cell carcinomaPathologic extranodal extensionDepth of invasionAJCC Cancer Staging ManualCancer Staging ManualSquamous cell carcinomaOverall survivalPT3N0 patientsStage migrationStaging ManualCell carcinomaStaging systemAJCC-8 staging systemPathologic tumor classificationNational Cancer DatabaseRisk of deathNew staging systemPStage IVBUpstaged tumorsAdjuvant treatmentDefinitive surgeryExtranodal extensionPostoperative radiotherapyPT classificationPT1 tumors
2018
Hypopharyngeal Cancer Treatment Delays: Benchmarks and Survival Association
Morse E, Berson E, Fujiwara R, Judson B, Mehra S. Hypopharyngeal Cancer Treatment Delays: Benchmarks and Survival Association. Otolaryngology 2018, 160: 267-276. PMID: 30324861, DOI: 10.1177/0194599818797605.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBenchmarkingCarcinoma, Squamous CellChemoradiotherapyCohort StudiesDisease-Free SurvivalFemaleHumansHypopharyngeal NeoplasmsLogistic ModelsMaleMiddle AgedMultivariate AnalysisPrognosisProportional Hazards ModelsRadiotherapy, ConformalRetrospective StudiesRisk AssessmentSurvival AnalysisTime-to-TreatmentTreatment OutcomeConceptsRadiation treatment durationOverall survivalInduction chemotherapyMedian durationConcurrent chemoradiationHypopharyngeal cancerCox proportional hazards regressionNational Cancer DatabaseProportional hazards regressionMultivariable logisticRetrospective cohortTreatment initiationMedicaid insuranceTreatment delayCancer HospitalHazards regressionNonwhite raceCancer DatabaseTreatment endSurvival associationsTreatment durationPatientsChemoradiationChemotherapyTreatment factorsPositive surgical margins in parotid malignancies: Institutional variation and survival association
Morse E, Fujiwara RJT, Judson B, Prasad ML, Mehra S. Positive surgical margins in parotid malignancies: Institutional variation and survival association. The Laryngoscope 2018, 129: 129-137. PMID: 30194762, DOI: 10.1002/lary.27221.Peer-Reviewed Original ResearchConceptsPositive surgical marginsPositive margin rateOverall survivalSurgical marginsHigh-volume facilitiesMargin ratePositive marginsParotid malignanciesMucoepidermoid carcinomaCox proportional hazards regressionOverall positive margin rateLow-grade mucoepidermoid carcinomaNational Cancer DatabaseProportional hazards regressionMultivariable logistic regressionPositive margin statusRetrospective database analysisParotid cancerMargin statusHazards regressionCancer DatabaseSurvival associationsDecreased oddsCystic carcinomaPatientsAssociation of Human Papillomavirus Status at Head and Neck Carcinoma Subsites With Overall Survival
Li H, Torabi SJ, Yarbrough WG, Mehra S, Osborn HA, Judson B. Association of Human Papillomavirus Status at Head and Neck Carcinoma Subsites With Overall Survival. JAMA Otolaryngology - Head & Neck Surgery 2018, 144: 519-525. PMID: 29801040, PMCID: PMC6583856, DOI: 10.1001/jamaoto.2018.0395.Peer-Reviewed Original ResearchConceptsHPV-positive statusHuman papillomavirus (HPV) statusOverall survivalHPV statusOral cavityHPV positivityRetrospective population-based cohort studyPopulation-based cohort studyCox multivariate regression modelNeck squamous cell carcinomaHPV-negative statusImproved overall survivalNational Cancer DatabaseHPV-negative tumorsHPV-positive tumorsIndependent prognostic factorHuman papillomavirus positivityUpper aerodigestive tractSquamous cell carcinomaLarge survival differencesCategory tumorsOropharynx subsiteCohort studyPrimary malignancyImproved survivalNational treatment times in oropharyngeal cancer treated with primary radiation or chemoradiation
Morse E, Judson B, Husain Z, Burtness B, Yarbrough W, Sasaki C, Cheraghlou S, Mehra S. National treatment times in oropharyngeal cancer treated with primary radiation or chemoradiation. Oral Oncology 2018, 82: 122-130. PMID: 29909886, DOI: 10.1016/j.oraloncology.2018.02.010.Peer-Reviewed Original ResearchConceptsRadiation treatment durationHuman papilloma virus-positive tumorsVirus-positive tumorsOverall survivalOropharyngeal cancerTreatment durationTreatment endMedian durationTreatment initiationTreatment delayHuman papilloma virus-associated tumorsHuman papilloma virus-negative tumorsEnd intervalOropharyngeal squamous cell carcinomaCox proportional hazards regressionNational Cancer DatabaseProportional hazards regressionSquamous cell carcinomaVirus-associated tumorsVirus-negative tumorsMultivariable logisticHazards regressionCell carcinomaHuman papillomaCancer DatabaseTreatment delays in laryngeal squamous cell carcinoma: A national cancer database analysis
Morse E, Fujiwara RJT, Judson B, Mehra S. Treatment delays in laryngeal squamous cell carcinoma: A national cancer database analysis. The Laryngoscope 2018, 128: 2751-2758. PMID: 29756382, DOI: 10.1002/lary.27247.Peer-Reviewed Original ResearchConceptsLaryngeal squamous cell carcinomaOverall survivalSquamous cell carcinomaTreatment initiationNonsurgical patientsSurgical patientsTotal treatment packageMedian durationRadiation treatmentTreatment delayCell carcinomaTreatment endNational Cancer Database AnalysisEnd intervalCox proportional hazards regressionNational Cancer DatabaseProportional hazards regressionMultivariable logistic regressionDuration of diagnosisHigh-volume facilitiesTreatment packageRadiotherapy durationAdjuvant treatmentHazards regressionInsurance statusPediatric Salivary Cancer: Epidemiology, Treatment Trends, and Association of Treatment Modality with Survival
Morse E, Fujiwara RJT, Husain Z, Judson B, Mehra S. Pediatric Salivary Cancer: Epidemiology, Treatment Trends, and Association of Treatment Modality with Survival. Otolaryngology 2018, 159: 553-563. PMID: 29688836, DOI: 10.1177/0194599818771926.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentBiopsy, NeedleCarcinoma, MucoepidermoidChemotherapy, AdjuvantChildChild, PreschoolCombined Modality TherapyCross-Sectional StudiesDatabases, FactualFemaleHumansImmunohistochemistryLogistic ModelsMaleMultivariate AnalysisNeoplasm InvasivenessNeoplasm StagingPrognosisProportional Hazards ModelsRadiotherapy, AdjuvantRetrospective StudiesSalivary Gland NeoplasmsSurvival AnalysisTreatment OutcomeConceptsImproved overall survivalOverall survivalHigh tumor gradeTreatment modalitiesTumor gradeSalivary cancerAdjuvant radiationMultivariable Cox proportional hazards regressionNational Cancer Database 2004Cox proportional hazards regressionTreatment factorsPatients 19 yearsHigh-risk patientsSubset of patientsMultivariable logistic regressionProportional hazards regressionUS national databaseHigh-grade tumorsSalivary gland cancerAcinar cell carcinomaPediatric patientsTumor characteristicsHazards regressionCell carcinomaGland cancerUpfront surgery versus definitive chemoradiotherapy in patients with human Papillomavirus-associated oropharyngeal squamous cell cancer
Kelly JR, Park HS, An Y, Yarbrough WG, Contessa JN, Decker R, Mehra S, Judson BL, Burtness B, Husain Z. Upfront surgery versus definitive chemoradiotherapy in patients with human Papillomavirus-associated oropharyngeal squamous cell cancer. Oral Oncology 2018, 79: 64-70. PMID: 29598952, DOI: 10.1016/j.oraloncology.2018.02.017.Peer-Reviewed Original ResearchConceptsNational Cancer DatabasePrimary surgeryOverall survivalAdjuvant chemoradiotherapyDefinitive chemoradiotherapyUpfront surgerySurgical patientsHuman papillomavirus-associated oropharyngeal squamous cell carcinomaOropharyngeal squamous cell carcinomaPropensity score-matched analysisOropharyngeal squamous cell cancerCox proportional hazards regressionMultivariable Cox regressionNon-private insuranceInferior overall survivalMargin-negative resectionSquamous cell cancerProportional hazards regressionSquamous cell carcinomaLog-rank testChi-square testClinicopathologic predictorsSimilar OSSurgery patientsTrimodal therapy