2021
A 2020 Update on Public Awareness of Head and Neck Cancers
Torabi SJ, Kasle DA, Su-Velez B, Mehra S, Day TA, Yarbrough WG, St. John M, Judson BL. A 2020 Update on Public Awareness of Head and Neck Cancers. Otolaryngology 2021, 166: 305-312. PMID: 33845657, DOI: 10.1177/01945998211006932.Peer-Reviewed Original ResearchConceptsHuman papillomavirusHPV's roleNeck cancerNeck Cancer Awareness WeekKnowledge of HNCSigns/symptomsFormer tobacco usersCross-sectional surveyFormer smokersOropharyngeal cancerRisk factorsTobacco usersElderly individualsRisk populationsAwareness rateUS populationOlder individualsFuture outreach effortsCancerCausal roleHNCAwareness WeekUS CensusExposureHead
2020
Sequencing of Sclerosing Microcystic Adenocarcinoma Identifies Mutational Burden and Somatic Variants Associated With Tumorigenesis
JIANG R, MARQUEZ J, TOWER JI, JACOBS D, CHEN W, MEHRA S, PRASAD ML, JUDSON BL. Sequencing of Sclerosing Microcystic Adenocarcinoma Identifies Mutational Burden and Somatic Variants Associated With Tumorigenesis. Anticancer Research 2020, 40: 6375-6379. PMID: 33109575, DOI: 10.21873/anticanres.14658.Peer-Reviewed Original ResearchConceptsMicrocystic adnexal carcinomaMutational burdenContext of immunosuppressionOral cavity neoplasiaCases of SMADiagnosis of SMAWhole-exome sequencingPotential molecular mechanismsImmunosuppression therapyNodal diseaseNeck dissectionPsoriatic arthritisResidual tumorAdnexal carcinomaPartial glossectomyTongue massSomatic variantsMicrocystic adenocarcinomaSMA casesExome sequencingGenomic profilesFunction mutationsTumorigenesisBurdenMolecular mechanismsAn Analysis of Otolaryngology Medical Malpractice Payments From the National Practitioner Data Bank
Breen CT, Mehra S. An Analysis of Otolaryngology Medical Malpractice Payments From the National Practitioner Data Bank. Otolaryngology 2020, 164: 589-594. PMID: 32691675, DOI: 10.1177/0194599820942498.Peer-Reviewed Original ResearchConceptsPatient ageNational Practitioner Data BankMalpractice paymentsRetrospective cross-sectional analysisMean paymentCross-sectional analysisInsignificant injuryBrain damageLifelong careMedian paymentPatientsNumber of otolaryngologistsMedical malpractice paymentsOtolaryngologistsInjurySeveritySignificant decreaseAgeAnnual numberDescriptive statisticsPayment amountAssociationYearsLinear regressionAssessing 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 reviewPositive 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 regressionGender disparities in head and neck cancer chemotherapy clinical trials participation and treatment
Benchetrit L, Torabi SJ, Tate JP, Mehra S, Osborn HA, Young MR, Burtness B, Judson BL. Gender disparities in head and neck cancer chemotherapy clinical trials participation and treatment. Oral Oncology 2019, 94: 32-40. PMID: 31178210, DOI: 10.1016/j.oraloncology.2019.05.009.Peer-Reviewed Original ResearchConceptsChemotherapy clinical trialsNational Cancer DatabaseClinical trialsDefinitive radiotherapyChemotherapy administrationNational Comprehensive Cancer Network guidelinesMultivariable logistic regression analysisNeck squamous cell carcinomaEnd Results ProgramSquamous cell carcinomaClinical trial participationLogistic regression analysisGeneral U.S. populationChemotherapy useDefinitive chemoradiotherapyNCCN guidelinesAdult patientsDefinitive treatmentMultivariable analysisNetwork guidelinesResults ProgramCell carcinomaTrial participationCancer DatabaseU.S. patients
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 carcinomaPatients
2017
Outcomes and reliability of the flow coupler in postoperative monitoring of head and neck free flaps
Fujiwara RJT, Dibble JM, Larson SV, Pierce ML, Mehra S. Outcomes and reliability of the flow coupler in postoperative monitoring of head and neck free flaps. The Laryngoscope 2017, 128: 812-817. PMID: 28988465, DOI: 10.1002/lary.26944.Peer-Reviewed Original ResearchAdultAgedAged, 80 and overFalse Positive ReactionsFemaleFree Tissue FlapsGraft SurvivalHead and Neck NeoplasmsHumansLogistic ModelsMaleMiddle AgedMonitoring, PhysiologicMouth NeoplasmsPlastic Surgery ProceduresPostoperative ComplicationsPostoperative PeriodReproducibility of ResultsRetrospective StudiesRheologySensitivity and SpecificityVenous ThrombosisYoung AdultA Comparison of Prognostic Ability of Staging Systems for Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma
Husain ZA, Chen T, Corso CD, Wang Z, Park H, Judson B, Yarbrough W, Deshpande H, Mehra S, Kuo P, Decker RH, Burtness BA. A Comparison of Prognostic Ability of Staging Systems for Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma. JAMA Oncology 2017, 3: 358-365. PMID: 27737449, DOI: 10.1001/jamaoncol.2016.4581.Peer-Reviewed Original ResearchConceptsOropharyngeal squamous cell cancerAJCC/UICC systemStaging systemStage IAStage IBHuman papillomavirusPrognostic abilityUICC systemAJCC/UICC staging systemStage IICurrent American Joint CommitteeOropharyngeal squamous cell carcinomaInternational Cancer Control (UICC) staging systemOropharyngeal cancer NetworkNational Cancer DatabasePrimary radiation therapyOverall survival rateAmerican Joint CommitteeCancer/UnionEdition staging systemKaplan-Meier methodSquamous cell cancerNovel staging systemSquamous cell carcinomaLog-rank testTreatment delays in oral cavity squamous cell carcinoma and association with survival
Fujiwara RJ, Judson BL, Yarbrough WG, Husain Z, Mehra S. Treatment delays in oral cavity squamous cell carcinoma and association with survival. Head & Neck 2017, 39: 639-646. PMID: 28236349, DOI: 10.1002/hed.24608.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCarcinoma, Squamous CellCause of DeathChemoradiotherapy, AdjuvantCohort StudiesCombined Modality TherapyDatabases, FactualDisease-Free SurvivalFemaleHead and Neck NeoplasmsHumansKaplan-Meier EstimateMaleMiddle AgedMouth NeoplasmsNeoplasm InvasivenessNeoplasm StagingPredictive Value of TestsPrognosisProportional Hazards ModelsRetrospective StudiesRisk AssessmentSquamous Cell Carcinoma of Head and NeckSurvival AnalysisTime-to-TreatmentUnited StatesConceptsSquamous cell carcinomaOral cavity squamous cell carcinomaNational Cancer Data BaseOverall survivalRT durationTotal treatment packageCox proportional hazards modelDecreased overall survivalProportional hazards modelTreatment packageBinary logistic regressionMedicaid insuranceTreatment delayCell carcinomaAcademic/research institutionsHazards modelLate PTSurgery delayTreatment durationRadiotherapySurgeryLogistic regressionDiagnosisDurationImpact of delay
2016
Proposing prognostic thresholds for lymph node yield in clinically lymph node‐negative and lymph node‐positive cancers of the oral cavity
Kuo P, Mehra S, Sosa JA, Roman SA, Husain ZA, Burtness BA, Tate JP, Yarbrough WG, Judson BL. Proposing prognostic thresholds for lymph node yield in clinically lymph node‐negative and lymph node‐positive cancers of the oral cavity. Cancer 2016, 122: 3624-3631. PMID: 27479645, DOI: 10.1002/cncr.30227.Peer-Reviewed Original ResearchConceptsNational Cancer DatabaseOral cavity cancerMortality hazard ratioLymph nodesHazard ratioNeck dissectionLymph node-negative cancersLymph node-positive cancersNode-positive cancersNode-positive cohortPositive lymph nodesTherapeutic neck dissectionEnd Results (SEER) databaseLymph node yieldHigh-volume centersExtensive neck dissectionMultiple cancer sitesNode-negative cancersOverall survivalHigher lymphPrognostic factorsTreatment guidelinesNode yieldResults databaseSurgical managementTreatment trends and survival effects of chemotherapy for hypopharyngeal cancer: Analysis of the National Cancer Data Base
Kuo P, Sosa JA, Burtness BA, Husain ZA, Mehra S, Roman SA, Yarbrough WG, Judson BL. Treatment trends and survival effects of chemotherapy for hypopharyngeal cancer: Analysis of the National Cancer Data Base. Cancer 2016, 122: 1853-1860. PMID: 27019213, DOI: 10.1002/cncr.29962.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCarcinoma, Squamous CellChemoradiotherapy, AdjuvantDatabases, FactualFemaleHead and Neck NeoplasmsHumansHypopharyngeal NeoplasmsKaplan-Meier EstimateMaleMiddle AgedProportional Hazards ModelsRadiotherapy, AdjuvantSquamous Cell Carcinoma of Head and NeckUnited StatesYoung AdultConceptsHypopharyngeal cancerDefinitive settingTreatment modalitiesSurvival rateNational Cancer Data BaseMultivariate Cox regression analysisKaplan-Meier survival curvesPrimary hypopharyngeal cancerUse of chemotherapyCox regression analysisDefinitive chemoradiotherapyAdjuvant chemoradiotherapyAdjuvant treatmentDefinitive radiotherapyAdult patientsOverall survivalClinical factorsDefinitive treatmentImproved survivalDistant metastasisSurvival outcomesChemoradiotherapyRadiotherapySurvival analysisSurvival curves
2015
National treatment patterns in patients presenting with Stage IVC head and neck cancer: analysis of the National Cancer Database
Schwam ZG, Burtness B, Yarbrough WG, Mehra S, Husain Z, Judson BL. National treatment patterns in patients presenting with Stage IVC head and neck cancer: analysis of the National Cancer Database. Cancer Medicine 2015, 4: 1828-1835. PMID: 26471244, PMCID: PMC5123708, DOI: 10.1002/cam4.546.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCombined Modality TherapyComorbidityDatabases, FactualFemaleHead and Neck NeoplasmsHumansKaplan-Meier EstimateMaleMiddle AgedNeoplasm MetastasisNeoplasm StagingPopulation SurveillanceRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesYoung AdultConceptsNational Cancer DatabaseSystemic therapyPalliative therapyTreatment patternsNeck cancerCancer DatabaseClinical trialsMedicaid/uninsured statusCox proportional hazards analysisCommon treatment regimenNational treatment patternsCharlson comorbidity scorePrimary disease siteRetrospective cohort analysisProportional hazards analysisRisk of deathNeck cancer patientsMedicare/Comorbidity scoreMetastatic headOverall survivalSystemic treatmentTreatment regimenDistant metastasisKaplan-MeierHospital readmission and 30‐day mortality after surgery for oral cavity cancer: Analysis of 21,681 cases
Luryi AL, Chen MM, Mehra S, Roman SA, Sosa JA, Judson BL. Hospital readmission and 30‐day mortality after surgery for oral cavity cancer: Analysis of 21,681 cases. Head & Neck 2015, 38: e221-e226. PMID: 25537226, DOI: 10.1002/hed.23973.Peer-Reviewed Original ResearchConceptsOral cavity squamous cell cancerSquamous cell cancerNational Cancer Data BaseHospital readmissionHigh-risk patientsUnplanned readmission rateComorbidity indexUnplanned readmissionNeck dissectionReadmission ratesOverall mortalityCell cancerStage T3Male sexRisk factorsRetrospective analysisAge 76Mortality rateReadmissionMortalityPatientsSurgeryT3T4YearsTreatment 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
Subscapular system of flaps: An 8‐year experience with 105 patients
Gibber MJ, Clain JB, Jacobson AS, Buchbinder D, Scherl S, Zevallos JP, Mehra S, Urken ML. Subscapular system of flaps: An 8‐year experience with 105 patients. Head & Neck 2014, 37: 1200-1206. PMID: 24800735, DOI: 10.1002/hed.23738.Peer-Reviewed Original ResearchConceptsSubscapular systemFree flapRetrospective medical chart reviewExtensive surgical defectsMedical chart reviewOverall success rateDonor siteSoft tissue componentSoft tissue elementsLarge muscle flapsChart reviewEarly mobilizationAlternative donor siteMuscle flapAdvanced agePatientsNeck reconstructionSurgical defectsVital structuresFirst choiceMaxillary defectsFlapMandibular defectsSuccess rateThe Effect of Surgeon Experience on the Detection of Metastatic Lymph Nodes in the Central Compartment and the Pathologic Features of Clinically Unapparent Metastatic Lymph Nodes: What Are We Missing When We Don't Perform a Prophylactic Dissection of Central Compartment Lymph Nodes in Papillary Thyroid Cancer?
Scherl S, Mehra S, Clain J, Dos Reis LL, Persky M, Turk A, Wenig B, Husaini H, Urken ML. The Effect of Surgeon Experience on the Detection of Metastatic Lymph Nodes in the Central Compartment and the Pathologic Features of Clinically Unapparent Metastatic Lymph Nodes: What Are We Missing When We Don't Perform a Prophylactic Dissection of Central Compartment Lymph Nodes in Papillary Thyroid Cancer? Thyroid 2014, 24: 1282-1288. PMID: 24787362, DOI: 10.1089/thy.2013.0600.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCarcinomaCarcinoma, PapillaryFalse Negative ReactionsFalse Positive ReactionsFemaleHashimoto DiseaseHumansIntraoperative PeriodLymph NodesLymphatic MetastasisMaleMiddle AgedNeck DissectionProfessional CompetenceRiskSensitivity and SpecificitySurgeonsThyroid Cancer, PapillaryThyroid NeoplasmsThyroidectomyYoung AdultConceptsProphylactic central neck dissectionPapillary thyroid cancerMetastatic lymph nodesExtranodal extensionLymph nodesOccult metastasesPositive nodesSurgeon experienceOccult nodesPathologic featuresThyroid cancerPresence of ENECentral compartment lymph nodesAdverse histologic featuresMultiple positive nodesPositive central nodesSenior surgeon's assessmentCentral neck dissectionFalse-negative casesGroup of surgeonsEvident nodesPreoperative evidenceProphylactic dissectionNeck dissectionRisk stratification
2013
Factors Predictive of Voice and Swallowing Outcomes after Anterior Approaches to the Cervical Spine
Mehra S, Heineman TE, Cammisa FP, Girardi FP, Sama AA, Kutler DI. Factors Predictive of Voice and Swallowing Outcomes after Anterior Approaches to the Cervical Spine. Otolaryngology 2013, 150: 259-265. PMID: 24367048, DOI: 10.1177/0194599813515414.Peer-Reviewed Original ResearchConceptsAnterior transcervical approachSpinal levelAnterior approachSurgical factorsCervical spineTranscervical approachPostoperative voiceHistorical cohort studyKaplan-Meier methodVoice complaintsCervical spine diseaseAcademic medical centerSwallowing complaintsCohort studySwallowing outcomesConsecutive patientsMedian timePostoperative issuesSwallowing problemsFactors PredictiveSpine diseaseNeck surgeonsMedical CenterHigh incidencePatients