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 genderChanges in Population-Level and Institutional-Level Prescribing Habits of Radioiodine Therapy for Papillary Thyroid Cancer
Jacobs D, Breen CT, Pucar D, Holt E, Judson BL, Mehra S. Changes in Population-Level and Institutional-Level Prescribing Habits of Radioiodine Therapy for Papillary Thyroid Cancer. Thyroid 2020, 31: 272-279. PMID: 32811347, DOI: 10.1089/thy.2020.0237.Peer-Reviewed Original ResearchConceptsPapillary thyroid cancerNational Cancer DatabaseThyroid cancerRadioactive iodine therapyNumber of patientsHospital-specific effectsIodine therapyAdvanced diseaseTotal thyroidectomyRadioiodine therapyPrescribing habitsRAI useCancer DatabaseMixed regression modelsPatientsJoinpoint analysisHospitalIndividual hospitalsCancerHospital selectionNational trendsThyroidectomyTherapySignificant declineRegression modelsPositive 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 therapyA Clinical Care Pathway to Reduce ICU Usage in Head and Neck Microvascular Reconstruction
Morse E, Henderson C, Carafeno T, Dibble J, Longley P, Chan E, Judson B, Yarbrough WG, Sasaki C, Mehra S. A Clinical Care Pathway to Reduce ICU Usage in Head and Neck Microvascular Reconstruction. Otolaryngology 2018, 160: 783-790. PMID: 30060705, DOI: 10.1177/0194599818782404.Peer-Reviewed Original ResearchConceptsClinical care pathwayLength of stayReadmission ratesFree flap patientsCare pathwayICU admissionSurgical complicationsFlap patientsIntensive care unit admissionNeck free flap patientsRoutine ICU admissionCare unit admissionNumber of patientsNeck microvascular reconstructionFree tissue transferReconstruction of headPrepathway groupUnit admissionPostoperative complicationsPostoperative lengthVentilatory supportMedical complicationsMedian lengthPatient populationPathway implementation
2023
Trends in Private Equity Acquisitions of US Otolaryngology Practices
Shah H, Salehi P, Torabi S, Bourdillon A, Wu K, Mehra S. Trends in Private Equity Acquisitions of US Otolaryngology Practices. Otolaryngology 2023, 169: 1094-1097. PMID: 37003295, DOI: 10.1002/ohn.342.Peer-Reviewed Original Research
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 characteristicsMucosal haemangioma in the setting of treatment with trastuzumab emtansine (T‐DM1)
Belzer A, Silber A, Mehra S, Gilani S, Leventhal JS. Mucosal haemangioma in the setting of treatment with trastuzumab emtansine (T‐DM1). British Journal Of Dermatology 2022, 187: e168-e168. PMID: 35633104, DOI: 10.1111/bjd.21654.Peer-Reviewed Case Reports and Technical NotesProphylactic Intraoperative Antibiotic Dosing in Head and Neck Surgery: Opportunities for Improvement and Future Study
Shah R, Cohen O, Panth N, Dibble J, Paolillo D, Cook A, Mehra S. Prophylactic Intraoperative Antibiotic Dosing in Head and Neck Surgery: Opportunities for Improvement and Future Study. Otolaryngology 2022, 169: 482-488. PMID: 36113029, DOI: 10.1177/01945998221126144.Peer-Reviewed Original ResearchConceptsIntraoperative antibiotic prophylaxisFree tissue transferAntibiotic prophylaxisAmpicillin-sulbactamNeck surgeryTissue transferAdherence ratesGuideline adherence rateProphylactic antibiotic regimenNeck oncologic surgeryRetrospective case seriesSingle academic centerSecondary exploratory analysisFrequency of administrationAntibiotic typeAntibiotic regimenGuideline adherencePostoperative infectionAntibiotic dosingCase seriesDosing recommendationsFuture studiesOncologic surgeryDose 2Dose 3
2021
Major Salivary Gland Cancer With Distant Metastasis Upon Presentation: Patterns, Outcomes, and Imaging Implications
Benchetrit L, Mehra S, Mahajan A, Rahmati RW, Judson BL, Edwards HA. Major Salivary Gland Cancer With Distant Metastasis Upon Presentation: Patterns, Outcomes, and Imaging Implications. Otolaryngology 2021, 167: 305-315. PMID: 34784258, DOI: 10.1177/01945998211058354.Peer-Reviewed Original ResearchConceptsDistant metastasisMajor salivary gland cancerPredictors of DMRate of DMSite of DMHigh-grade mucoepidermoid carcinomaCancer-accredited hospitalsComputed tomography neckNational Cancer DatabaseCommon metastatic siteKaplan-Meier methodCox regression analysisLog-rank testSalivary duct carcinomaSalivary gland cancerRegression analysisMultivariate regression analysisHigh rateCancer presentationRetrospective cohortBone metastasesHistologic subtypeMetastatic sitesTumor histologyDuct carcinomaBrachytherapy and non-cancer mortality in patients with oral cavity and oropharynx SCCs
Yu J, Tsay C, Sasaki C, Son YH, Decker RH, Mehra S, Burtness B. Brachytherapy and non-cancer mortality in patients with oral cavity and oropharynx SCCs. Oral Oncology 2021, 122: 105585. PMID: 34688055, DOI: 10.1016/j.oraloncology.2021.105585.Peer-Reviewed Original ResearchConceptsNon-cancer mortalitySecond primary cancerExternal beam radiationOPC patientsPrimary cancerOral cavityHigher cancer-specific mortalityOropharyngeal squamous cell cancerBrachytherapy-treated patientsElectronic medical record dataImpact of brachytherapyInstitutional tumor registryCancer-specific mortalitySquamous cell cancerProportional hazards regressionCause of deathMedical record dataBeam radiationEligible patientsMortality HROropharynx SCCPrimary malignancySmoking historyPrimary outcomeTreatment regimenThe impact of a double vein anastomoses on doppler's loss of signal rates
Cohen O, Morse E, Fujiwara RJT, Dibble J, Pierce M, Mehra S. The impact of a double vein anastomoses on doppler's loss of signal rates. European Journal Of Surgical Oncology 2021, 48: 27-31. PMID: 34610861, DOI: 10.1016/j.ejso.2021.09.021.Peer-Reviewed Original ResearchExtranodal 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 IA 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 CensusExposureHeadAnesthesia screen use may impact operating room communication practices in otolaryngology
Bourdillon AT, Mehra S, Rahmati R, Judson B, Edwards HA. Anesthesia screen use may impact operating room communication practices in otolaryngology. American Journal Of Otolaryngology 2021, 42: 103000. PMID: 33812208, DOI: 10.1016/j.amjoto.2021.103000.Peer-Reviewed Original Research
2020
Hyperprogression of a Sinonasal Squamous Cell Carcinoma Following Programmed Cell Death Protein-1 Checkpoint Blockade
Izreig S, Alzahrani F, Earles J, Mehra S, Judson BL, Pan Z, Rahmati RW. Hyperprogression of a Sinonasal Squamous Cell Carcinoma Following Programmed Cell Death Protein-1 Checkpoint Blockade. JAMA Otolaryngology - Head & Neck Surgery 2020, 146: 1176-1178. PMID: 32940637, DOI: 10.1001/jamaoto.2020.2584.Peer-Reviewed Original ResearchRevisiting 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 databaseSequencing 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 mechanismsThe 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 analysisCohortAn 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 regression