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
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 ResearchMeSH KeywordsCarcinomaHumansNeoplasm MetastasisNeoplasm StagingPrognosisRetrospective StudiesSalivary Gland NeoplasmsTomography, X-Ray ComputedConceptsDistant 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 carcinomaExtranodal 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 I
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
2019
Clinical Outcomes of Head and Neck Cancer Patients Who Undergo Resection, But Forgo Adjuvant Therapy
LOGANADANE G, KANN BH, PARK HS, JOHNSON SB, MEHRA S, JUDSON BL, BHATIA A, BELKACEMI Y, YARBROUGH WG, BURTNESS B, HUSAIN ZA. Clinical Outcomes of Head and Neck Cancer Patients Who Undergo Resection, But Forgo Adjuvant Therapy. Anticancer Research 2019, 39: 4885-4890. PMID: 31519591, DOI: 10.21873/anticanres.13674.Peer-Reviewed Original ResearchConceptsLocoregional recurrence-free survivalAdjuvant therapyNeck squamous cell carcinomaOutcomes of patientsRecurrence-free survivalSquamous cell carcinomaNeck cancer patientsHNSCC patientsClinical outcomesRecurrence rateCell carcinomaMean TTPCancer patientsPatientsTherapyResectionMonthsOutcomesHNSCCSurgeryCarcinomaHeadIncidenceProgressionMargins 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 reviewIs 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 marginsPathologic 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
Adjuvant Chemotherapy Is Associated With Improved Survival for Late‐Stage Salivary Squamous Cell Carcinoma
Cheraghlou S, Schettino A, Zogg CK, Otremba MD, Bhatia A, Park HS, Osborn HA, Mehra S, Yarbrough WG, Judson BL. Adjuvant Chemotherapy Is Associated With Improved Survival for Late‐Stage Salivary Squamous Cell Carcinoma. The Laryngoscope 2018, 129: 883-889. PMID: 30151947, DOI: 10.1002/lary.27444.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarcinoma, Squamous CellChemoradiotherapy, AdjuvantChemotherapy, AdjuvantCombined Modality TherapyFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNeoplasm StagingPropensity ScoreProportional Hazards ModelsRadiotherapy, AdjuvantRetrospective StudiesSalivary Gland NeoplasmsSurvival RateTreatment OutcomeConceptsLate-stage patientsSquamous cell carcinomaAdjuvant radiotherapyAdjuvant therapyAdjuvant chemoradiotherapyAdjuvant chemotherapyImproved survivalCell carcinomaImproved long-term survivalCox survival regressionPrimary cutaneous malignanciesUnique disease entityAddition of chemotherapyNational Cancer DatabaseEarly-stage diseaseFive-year survivalEarly-stage patientsKaplan-Meier analysisParotid gland cancerLate stage groupLong-term survivalSurvival benefitCutaneous malignanciesPoor prognosisRetrospective studyTreatment 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 cancerSalvage 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
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 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
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-MeierTreatment 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 DatabaseImproving the Quality of Thyroid Cancer Care: How Does the Thyroid Cancer Care Collaborative Cross the Institute of Medicine's Quality Chasm?
Mehra S, Tuttle RM, Bergman D, Bernet V, Brett E, Cobin R, Doherty G, Klopper J, Lee S, Machac J, Milas M, Mechanick JI, Orloff L, Randolph G, Ross DS, Smallridge R, Terris D, Tufano R, Alon E, Clain J, Dos Reis L, Scherl S, Urken ML. Improving the Quality of Thyroid Cancer Care: How Does the Thyroid Cancer Care Collaborative Cross the Institute of Medicine's Quality Chasm? Thyroid 2014, 24: 615-624. PMID: 24512449, DOI: 10.1089/thy.2013.0441.Peer-Reviewed Original ResearchConceptsThyroid Cancer Care CollaborativeInformation technologyInstitute of MedicineDecision-making modulePortability of dataThyroid cancer careWorkflow integrationCancer careQuality ChasmIOM recommendationsHealthcare deliveryCancer care deliveryThyroid cancer managementVirtual tumor boardsCare CollaborativeTumor boardCancer managementHealthcare organizationsCare processesScoring systemCare deliveryWeb-based programCurrent systemModuleClinicians