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
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
Brachytherapy 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 ResearchMeSH KeywordsBrachytherapyCarcinoma, Squamous CellHumansMortalityMouth NeoplasmsNeoplasms, Second PrimaryOropharyngeal NeoplasmsSmokersSquamous Cell Carcinoma of Head and NeckConceptsNon-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 regimen
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 database
2018
National 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 ResearchMeSH KeywordsAgedCarcinoma, Squamous CellChemoradiotherapyFemaleHumansMaleMiddle AgedOropharyngeal NeoplasmsPrognosisRetrospective StudiesSurvival AnalysisTime FactorsConceptsRadiation 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 DatabaseUpfront 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 ResearchMeSH KeywordsAgedAlphapapillomavirusChemoradiotherapyFemaleHumansMaleMiddle AgedOropharyngeal NeoplasmsProspective StudiesSquamous Cell Carcinoma of Head and NeckSurvival AnalysisConceptsNational 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
2017
Treatment deintensification in human papillomavirus‐positive oropharynx cancer: Outcomes from the National Cancer Data Base
Cheraghlou S, Yu PK, Otremba MD, Park HS, Bhatia A, Zogg CK, Mehra S, Yarbrough WG, Judson BL. Treatment deintensification in human papillomavirus‐positive oropharynx cancer: Outcomes from the National Cancer Data Base. Cancer 2017, 124: 717-726. PMID: 29243245, DOI: 10.1002/cncr.31104.Peer-Reviewed Original ResearchConceptsNational Cancer Data BaseStage III diseaseTriple-modality therapyAdjuvant radiotherapyOropharyngeal cancerStage IHuman papillomavirus-positive oropharyngeal cancerUnivariate Kaplan-Meier analysisAvoidance of chemotherapyDeintensification of treatmentEdition stage IStage II diseaseMultivariate Cox regressionAmerican Joint CommitteeKaplan-Meier analysisDisease stage groupsForm of treatmentTreatment deintensificationAdjuvant chemoradiotherapyDefinitive radiotherapyTreatment intensificationFavorable prognosisImproved survivalCox regressionRetrospective studyA 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 test