Featured Publications
Clinical 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
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 ResearchMeSH KeywordsAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalCarcinoma, Squamous CellDisease ProgressionHumansMaleMaxillary Sinus NeoplasmsMiddle AgedTumor BurdenRevisiting 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
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 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
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 factorsAdjuvant 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 studyAssociation of Human Papillomavirus Status at Head and Neck Carcinoma Subsites With Overall Survival
Li H, Torabi SJ, Yarbrough WG, Mehra S, Osborn HA, Judson B. Association of Human Papillomavirus Status at Head and Neck Carcinoma Subsites With Overall Survival. JAMA Otolaryngology - Head & Neck Surgery 2018, 144: 519-525. PMID: 29801040, PMCID: PMC6583856, DOI: 10.1001/jamaoto.2018.0395.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, Squamous CellFemaleHead and Neck NeoplasmsHumansMaleMiddle AgedPapillomavirus InfectionsPrognosisRetrospective StudiesSurvival AnalysisConceptsHPV-positive statusHuman papillomavirus (HPV) statusOverall survivalHPV statusOral cavityHPV positivityRetrospective population-based cohort studyPopulation-based cohort studyCox multivariate regression modelNeck squamous cell carcinomaHPV-negative statusImproved overall survivalNational Cancer DatabaseHPV-negative tumorsHPV-positive tumorsIndependent prognostic factorHuman papillomavirus positivityUpper aerodigestive tractSquamous cell carcinomaLarge survival differencesCategory tumorsOropharynx subsiteCohort studyPrimary malignancyImproved survivalNational 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 DatabaseTreatment 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 statusSalvage 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
Demethylation Therapy as a Targeted Treatment for Human Papillomavirus–Associated Head and Neck Cancer
Biktasova A, Hajek M, Sewell A, Gary C, Bellinger G, Deshpande HA, Bhatia A, Burtness B, Judson B, Mehra S, Yarbrough WG, Issaeva N. Demethylation Therapy as a Targeted Treatment for Human Papillomavirus–Associated Head and Neck Cancer. Clinical Cancer Research 2017, 23: 7276-7287. PMID: 28916527, DOI: 10.1158/1078-0432.ccr-17-1438.Peer-Reviewed Original ResearchConceptsClinical trialsHNSCC cellsMatrix metalloproteinasesHuman papillomavirus-associated headNeck squamous cell carcinomaSquamous cell carcinomaAbility of HPVClin Cancer ResTumor cell proliferationNeck cancer cellsWindow trialsCell carcinomaEffective therapyPreclinical modelsHPVHPV oncogenesMouse modelMouse blood vesselsDNA demethylating agentHNSCCXenografted tumorsHPV genesIFN responseTherapyTumor samplesTreatment guidelines and patterns of care in oral cavity squamous cell carcinoma: Primary surgical resection vs. nonsurgical treatment
Fujiwara RJT, Burtness B, Husain ZA, Judson BL, Bhatia A, Sasaki CT, Yarbrough WG, Mehra S. Treatment guidelines and patterns of care in oral cavity squamous cell carcinoma: Primary surgical resection vs. nonsurgical treatment. Oral Oncology 2017, 71: 129-137. PMID: 28688680, DOI: 10.1016/j.oraloncology.2017.06.013.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarcinoma, Squamous CellFemaleHealth Services AccessibilityHumansMaleMiddle AgedMouth NeoplasmsPractice Guidelines as TopicSurvival AnalysisConceptsOral cavity squamous cell carcinomaNational Cancer Data BaseLate-stage diseasePrimary nonsurgical treatmentOral cavity malignancyNonsurgical treatmentSquamous cell carcinomaOverall survivalSurgical resectionCell carcinomaTreatment modalitiesNational Comprehensive Cancer Network Clinical Practice GuidelinesAcademic/research programMultimodality clinical trialsDefinitive radiation therapyImproved overall survivalDecreased overall survivalPrimary surgical resectionOral cavity cancerNon-randomized natureClinical practice guidelinesPatterns of careNon-white raceProportional hazards modelBinary logistic regressionA 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
Treatment 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
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