Featured Publications
Positive margin rates and predictors in transoral robotic surgery after federal approval: A national quality study
Hanna J, Morse E, Brauer PR, Judson B, Mehra S. Positive margin rates and predictors in transoral robotic surgery after federal approval: A national quality study. Head & Neck 2019, 41: 3064-3072. PMID: 31058417, DOI: 10.1002/hed.25792.Peer-Reviewed Original ResearchConceptsPositive margin rateTransoral robotic surgeryLow positive margin rateLow-volume facilitiesHigh-volume facilitiesPositive marginsT classificationMargin rateHuman papilloma virus (HPV) statusRobotic surgeryLymph-vascular invasionNational Cancer DatabaseMargin statusRetrospective reviewTumor subsiteVirus statusCancer DatabaseMultivariable regressionLinear associationPatientsSurgeryQuality studiesStatusAssociationClinical value of transoral robotic surgery: Nationwide results from the first 5 years of adoption
Li H, Torabi SJ, Park HS, Yarbrough WG, Mehra S, Choi R, Judson BL. Clinical value of transoral robotic surgery: Nationwide results from the first 5 years of adoption. The Laryngoscope 2018, 129: 1844-1855. PMID: 30575965, DOI: 10.1002/lary.27740.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, Squamous CellChemoradiotherapy, AdjuvantChi-Square DistributionCombined Modality TherapyDatabases, FactualFemaleHumansKaplan-Meier EstimateMaleMargins of ExcisionMiddle AgedMultivariate AnalysisNatural Orifice Endoscopic SurgeryNeoplasm StagingOropharyngeal NeoplasmsProportional Hazards ModelsRegression AnalysisRetrospective StudiesRobotic Surgical ProceduresTreatment OutcomeUnited StatesConceptsOropharyngeal squamous cell carcinomaTransoral robotic surgeryTransoral laser microsurgeryNonrobotic surgeryTORS patientsPositive marginsTLM patientsLower likelihoodT2 oropharyngeal squamous cell carcinomaEarly stage oropharyngeal squamous cell carcinomaLong-term oncologic outcomesUse of TORSKaplan-Meier log-rank testRobotic surgeryNational Cancer DatabaseMajority of patientsMultivariate Cox analysisSquamous cell carcinomaLog-rank testChi-square testCox multivariateN3 diseaseAdjuvant chemoradiotherapyAdjuvant radiotherapyAdjuvant therapy
2020
The 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 analysisCohortAssessing National Utilization Trends and Outcomes of Robotic and Endoscopic Thyroidectomy in the United States
Jacobs D, Torabi SJ, Gibson C, Rahmati R, Mehra S, Judson BL. Assessing National Utilization Trends and Outcomes of Robotic and Endoscopic Thyroidectomy in the United States. Otolaryngology 2020, 163: 947-955. PMID: 32539533, DOI: 10.1177/0194599820927699.Peer-Reviewed Original ResearchConceptsNational Cancer DatabaseEndoscopic thyroid surgeryRobotic thyroid surgeryThyroid surgeryOpen surgeryRobotic approachNational utilization trendsUnplanned hospital readmissionMultivariable logistic regressionOutcomes of roboticsPostoperative mortalityWorse morbidityComplication rateHospital readmissionEndoscopic thyroidectomyMortality outcomesPositive marginsSurgical approachNational cohortCancer DatabasePatient outcomesEndoscopic approachRetrospective analysisSurgeryOpen approach
2019
Margins in Laryngeal Squamous Cell Carcinoma Treated with Transoral Laser Microsurgery: A National Database Study
Hanna J, Brauer PR, Morse E, Mehra S. Margins in Laryngeal Squamous Cell Carcinoma Treated with Transoral Laser Microsurgery: A National Database Study. Otolaryngology 2019, 161: 986-992. PMID: 31476984, DOI: 10.1177/0194599819874315.Peer-Reviewed Original ResearchConceptsPositive margin rateLaryngeal squamous cell carcinomaPercent of patientsSquamous cell carcinomaPositive marginsTransoral laser microsurgeryMargin rateMargin statusT stageCell carcinomaNational Cancer DatabaseNational database studyMultivariable logistic regressionProper patient selectionEquivalent survival benefitLaser microsurgeryLaryngeal laser surgeryMicrosurgery resectionT3 tumorsNonacademic centersSurvival benefitGlottic tumorsMultivariable analysisPatient selectionRetrospective reviewPreoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins
Benchetrit L, Torabi SJ, Morse E, Mehra S, Rahmati R, Osborn HA, Judson BL. Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins. The Laryngoscope 2019, 130: 1450-1458. PMID: 31411749, DOI: 10.1002/lary.28224.Peer-Reviewed Original ResearchConceptsPreoperative biopsyParotid malignanciesSurgical marginsPositive marginsClinical T1 stageNational Cancer DatabaseClinical T stageClinical N stageHigh-volume centersSubgroup of patientsMultivariable logistic regressionEarly clinical stageChi-square testAdjuvant therapyRetrospective cohortYounger patientsT stageClinical stageSurgical outcomesVolume centersBiopsy useCancer DatabaseN stageBiopsyPatientsPositive 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 regression
2018
Positive 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 carcinomaPatientsSalvage Surgery after Radiation Failure in T1/T2 Larynx Cancer: Outcomes following Total versus Conservation Surgery
Cheraghlou S, Kuo P, Mehra S, Yarbrough WG, Judson BL. Salvage Surgery after Radiation Failure in T1/T2 Larynx Cancer: Outcomes following Total versus Conservation Surgery. Otolaryngology 2018, 158: 497-504. PMID: 29292665, DOI: 10.1177/0194599817742596.Peer-Reviewed Original ResearchConceptsPositive surgical marginsSalvage surgeryTotal laryngectomyConservation laryngeal surgeryLarynx cancerRadiation failureLaryngeal surgerySurgical marginsConservation surgeryPartial laryngectomyUnivariate Kaplan-Meier analysisSalvage laryngeal surgeryNational Cancer DatabaseSalvage total laryngectomyKaplan-Meier analysisSingle-institution studyInherent selection biasLarynx cancer casesLack of evidenceSurgery typeClinical outcomesPoor outcomePositive marginsRetrospective studyCancer Database
2016
Pretreatment predictors of adjuvant chemoradiation in patients receiving transoral robotic surgery for squamous cell carcinoma of the oropharynx: a case control study
Subramanian HE, Park HS, Barbieri A, Mahajan A, Judson BL, Mehra S, Yarbrough WG, Burtness BA, Husain ZA. Pretreatment predictors of adjuvant chemoradiation in patients receiving transoral robotic surgery for squamous cell carcinoma of the oropharynx: a case control study. Cancers Of The Head & Neck 2016, 1: 7. PMID: 31093337, PMCID: PMC6460847, DOI: 10.1186/s41199-016-0008-7.Peer-Reviewed Original ResearchTransoral robotic surgeryPositive lymph nodesPreoperative patient characteristicsLymph node sizePositive surgical marginsExtracapsular extensionLymph nodesPatient characteristicsSurgical marginsAdjuvant chemoradiationNeck dissectionIndependent predictorsPositive marginsLymph node extracapsular extensionSingle-institution retrospective studyNode sizeLogistic regressionRobotic surgeryNodal extracapsular extensionPreoperative lymph nodeEarly-stage diseaseMajority of patientsSquamous cell carcinomaCase-control studyPrimary oropharyngeal cancer
2015
Treatment Factors Associated With Survival in Early-Stage Oral Cavity Cancer: Analysis of 6830 Cases From the National Cancer Data Base
Luryi AL, Chen MM, Mehra S, Roman SA, Sosa JA, Judson BL. Treatment Factors Associated With Survival in Early-Stage Oral Cavity Cancer: Analysis of 6830 Cases From the National Cancer Data Base. JAMA Otolaryngology - Head & Neck Surgery 2015, 141: 593-598. PMID: 25974757, DOI: 10.1001/jamaoto.2015.0719.Peer-Reviewed Original ResearchConceptsOral cavity squamous cell cancerNational Cancer Data BaseNeck dissectionOverall survivalImproved survivalRadiation therapyTreatment factorsMultivariable analysisPositive marginsStage IEarly-stage oral cavity cancerOral cavity squamous cell carcinomaElimination of patientsTumor prognostic featuresAdjuvant radiation therapyOccult nodal diseaseOral cavity cancerSquamous cell cancerSquamous cell carcinomaPopulation-level dataAdjuvant chemotherapyPathologic restagingNodal diseaseMost patientsPrognostic impact
2014
Positive Surgical Margins in Early Stage Oral Cavity Cancer: An Analysis of 20,602 Cases
Luryi AL, Chen MM, Mehra S, Roman SA, Sosa JA, Judson BL. Positive Surgical Margins in Early Stage Oral Cavity Cancer: An Analysis of 20,602 Cases. Otolaryngology 2014, 151: 984-990. PMID: 25257901, DOI: 10.1177/0194599814551718.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnalysis of VarianceCarcinoma, Squamous CellConfidence IntervalsDatabases, FactualDisease-Free SurvivalFemaleHumansMaleMiddle AgedMouth NeoplasmsMultivariate AnalysisNeoplasm InvasivenessNeoplasm Recurrence, LocalNeoplasm StagingOral Surgical ProceduresPrognosisRetrospective StudiesRisk AssessmentSurvival AnalysisTreatment OutcomeConceptsOral cavity cancerEarly oral cavity cancerPositive surgical marginsPositive marginsMargin statusSurgical marginsCase volumeEarly-stage oral cavity cancerOral cavity squamous cell cancerDifficulty of resectionNational Cancer DatabaseStage II diseaseEarly oral cancerHospital case volumeSquamous cell cancerTreatment facility typeFloor of mouthQuality of careUseful quality measureTumor factorsClinical factorsCell cancerCancer CenterOral cancerCancer Database