Featured Publications
Identifying Opportunities to Deliver High‐Quality Cancer Care Across a Health System: A Clinical Responsibility
Shah H, Cohen O, Bourdillon A, Burtness B, Boffa D, Young M, Judson B, Mehra S. Identifying Opportunities to Deliver High‐Quality Cancer Care Across a Health System: A Clinical Responsibility. Otolaryngology 2024, 171: 445-456. PMID: 38606669, DOI: 10.1002/ohn.755.Peer-Reviewed Original ResearchOral squamous cell carcinomaHealth systemCancer careLymph node yieldDeliver high-quality cancer careHigh-quality cancer careBaseline quality of careReporting of Observational StudiesFragmentation of careQuality of careFacility typeCommunity facilitiesOdds of positive surgical marginsAssociated with increased oddsPositive surgical margin rateCombination groupAcademic centersPositive surgical marginsTreating facility typeSurgical margin ratePrimary outcome measureSquamous cell carcinomaGuideline-adherent treatmentCombined careEpidemiology guidelinesClinical 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 therapyTreatment Delays in Primarily Resected Oropharyngeal Squamous Cell Carcinoma: National Benchmarks and Survival Associations
Morse E, Judson B, Husain Z, Burtness B, Yarbrough WG, Sasaki C, Cheraghlou S, Mehra S. Treatment Delays in Primarily Resected Oropharyngeal Squamous Cell Carcinoma: National Benchmarks and Survival Associations. Otolaryngology 2018, 159: 987-997. PMID: 30060700, DOI: 10.1177/0194599818779052.Peer-Reviewed Original ResearchHPV-positive patientsRadiation treatment durationTotal treatment packageOverall survivalTreatment initiationTreatment durationEnd intervalOropharyngeal cancerTreatment delayTreatment packageOropharyngeal squamous cell carcinomaCox proportional hazards regressionMultivariable logistic regression analysisRadiation treatmentRetrospective cross-sectional analysisNational Cancer DatabaseProportional hazards regressionSquamous cell carcinomaDuration of diagnosisLogistic regression analysisNational benchmarksCross-sectional analysisMedian durationOverall cohortHazards regression
2024
Detection, Patterns, and Outcomes of Recurrent HPV-Positive Oropharyngeal Squamous Cell Carcinoma
Shah R, Wilkins S, Safranek C, Shah H, Brophy C, Mehra S. Detection, Patterns, and Outcomes of Recurrent HPV-Positive Oropharyngeal Squamous Cell Carcinoma. JAMA Otolaryngology - Head & Neck Surgery 2024, 150 PMID: 39418066, DOI: 10.1001/jamaoto.2024.3237.Peer-Reviewed Original ResearchHPV-positive oropharyngeal squamous cell carcinomaOropharyngeal squamous cell carcinomaSquamous cell carcinomaDistant metastasisDisease recurrenceCell carcinomaRecurrence detectionHuman papillomavirus (HPV)-positive oropharyngeal squamous cell carcinomaCohort studyMethod of recurrence detectionSurveillance strategiesSurveillance imaging strategiesLocation of recurrencePatterns of recurrenceFollow-up timeElectronic medical record reviewOptimal surveillance strategyPercentage of patientsRetrospective cohort studyIncidence of DMTertiary care hospitalDiagnosis to deathMedical record reviewRecurrence cohortRegional recurrencePatterns of Care for T1 Glottic Squamous Cell Carcinomas from 2004–2020
Malik D, Jacobs D, Fereydooni S, Park H, Mehra S. Patterns of Care for T1 Glottic Squamous Cell Carcinomas from 2004–2020. The Laryngoscope 2024, 134: 3633-3644. PMID: 38411338, DOI: 10.1002/lary.31363.Peer-Reviewed Original ResearchGlottic squamous cell carcinomaT1 glottic squamous cell carcinomaSquamous cell carcinomaDual-modality treatmentOver-treatmentT1a tumorsCell carcinomaTreatment regimensOverall treatment modalityNational Cancer DatabaseRate of surgeryYear of treatmentMultivariate logistic regressionCochran-Armitage testT1b tumorsT1b diseaseCancer DatabaseOver-treatedTreatment modalitiesTreatment patternsAssociated with greater likelihoodSurgeryPatientsTumorLogistic regressionThe Impact of Four Smoking Metrics on Survival After Diagnosis with HPV+ Oropharyngeal Cancer
Wilkins S, Shah R, Safranek C, Shah H, Mehra S. The Impact of Four Smoking Metrics on Survival After Diagnosis with HPV+ Oropharyngeal Cancer. The Laryngoscope 2024, 134: 3158-3164. PMID: 38294283, DOI: 10.1002/lary.31319.Peer-Reviewed Original ResearchOropharyngeal squamous cell carcinomaRecurrence-free survivalHPV+ oropharyngeal squamous cell carcinomaOverall survivalPack-yearsTobacco useRetrospective review of patientsImpact overall survivalReview of patientsSquamous cell carcinomaSmoking metricsInferior OSImpact of tobacco useMetastatic diseaseImpact of smokingPrognostic significanceRetrospective reviewCell carcinomaSmoking historyUnivariate analysisNever-smokersMultivariate analysisSmoking statusPatientsInclusion criteria
2023
Automated AJCC Restaging for Oropharyngeal Cancer Research
Safranek C, Wilkins S, Shah R, Mehra S. Automated AJCC Restaging for Oropharyngeal Cancer Research. Otolaryngology 2023, 170: 627-629. PMID: 37855637, DOI: 10.1002/ohn.558.Peer-Reviewed Original ResearchOropharyngeal squamous cell carcinomaComputational toolsData setsLarge data setsOpen-source designSimilar toolsHuman papillomavirus-positive oropharyngeal squamous cell carcinomaAmerican Joint CommitteeHPV-negative counterpartsSquamous cell carcinomaGuideline updateCell carcinomaAJCC editionToolEdition criteriaClinical tumorsJoint CommitteeSetCancer typesAlgorithmAccurate analysisAJCCCancer researchRole of PET/CT in Oropharyngeal Cancers
Avery E, Joshi K, Mehra S, Mahajan A. Role of PET/CT in Oropharyngeal Cancers. Cancers 2023, 15: 2651. PMID: 37174116, PMCID: PMC10177278, DOI: 10.3390/cancers15092651.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 databaseThe role of vitamin D in head and neck cancer
Izreig S, Hajek M, Edwards HA, Mehra S, Sasaki C, Judson BL, Rahmati RW. The role of vitamin D in head and neck cancer. Laryngoscope Investigative Otolaryngology 2020, 5: 1079-1088. PMID: 33364397, PMCID: PMC7752058, DOI: 10.1002/lio2.469.Peer-Reviewed Original ResearchVitamin DIntensive multi-modal therapyNeck squamous cell carcinomaManagement of HNSCCRise of immunotherapySet of malignanciesSquamous cell carcinomaMulti-modal therapyTreatment of HNSCCActive hormone calcitriolLimited data existsConsiderable morbiditySignificant morbiditySafe interventionCell carcinomaNeck cancerHormone calcitriolPatient outcomesEffective modalityHNSCCAdvanced stageMEDLINE databaseAvailable evidenceCalcium physiologyMorbidity
2019
1149P Pathologic staging changes in oral cavity squamous cell carcinoma: Stage migration and implications for adjuvant treatment
Husain Z, Lee N, Eskander A, Park H, mehra S, Burtness B. 1149P Pathologic staging changes in oral cavity squamous cell carcinoma: Stage migration and implications for adjuvant treatment. Annals Of Oncology 2019, 30: v466. DOI: 10.1093/annonc/mdz252.041.Peer-Reviewed Original ResearchOral cavity squamous cell carcinomaPathologic extranodal extensionDepth of invasionSquamous cell carcinomaPT3N0 patientsOverall survivalStage migrationCell carcinomaStaging systemAJCC-8 staging systemFive-year overall survivalNational InstitutePathologic tumor classificationNational Cancer DatabaseAmerican Joint CommitteeRisk of deathNew staging systemBristol-Myers SquibbPStage IVBUpstaged tumorsDefinitive surgeryPostoperative radiotherapyPT3 tumorsAdjuvant treatmentExtranodal extensionClinical 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 reviewPathologic 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 tumorsGender 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
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 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 ResearchConceptsHPV-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 ResearchConceptsRadiation 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 status