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 studiesStatusAssociation
2024
Predisposing, Enabling, and Need Factors Driving Palliative Care Use in Head and Neck Cancer
Fereydooni S, Valdez C, William L, Malik D, Mehra S, Judson B. Predisposing, Enabling, and Need Factors Driving Palliative Care Use in Head and Neck Cancer. Otolaryngology 2024, 171: 1069-1082. PMID: 38796734, DOI: 10.1002/ohn.819.Peer-Reviewed Original ResearchPalliative careAssociated with palliative carePC usePalliative care useAnderson Behavioral ModelHealth service useHigher incomePrivate insuranceHead and neck cancerNational Cancer DatabaseHigher comorbidity indexMultivariate logistic regressionCare useService useMonths of lifeNeed factorsInformational counselingEnabling factorsHispanic ethnicityPC indicatorsCancer DatabaseNeck cancerBlack raceRetrospective studyCurative treatmentPatterns 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 regression
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 databaseThe 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 analysisCohortAssessing National Utilization Trends and Outcomes of Robotic and Endoscopic Thyroidectomy in the United States
Jacobs D, Torabi SJ, Gibson C, Rahmati R, Mehra S, Judson BL. Assessing National Utilization Trends and Outcomes of Robotic and Endoscopic Thyroidectomy in the United States. Otolaryngology 2020, 163: 947-955. PMID: 32539533, DOI: 10.1177/0194599820927699.Peer-Reviewed Original ResearchConceptsNational Cancer DatabaseEndoscopic thyroid surgeryRobotic thyroid surgeryThyroid surgeryOpen surgeryRobotic approachNational utilization trendsUnplanned hospital readmissionMultivariable logistic regressionOutcomes of roboticsPostoperative mortalityWorse morbidityComplication rateHospital readmissionEndoscopic thyroidectomyMortality outcomesPositive marginsSurgical approachNational cohortCancer DatabasePatient outcomesEndoscopic approachRetrospective analysisSurgeryOpen approachAdjuvant external beam radiotherapy for surgically resected, nonmetastatic anaplastic thyroid cancer
Saeed NA, Kelly JR, Deshpande HA, Bhatia AK, Burtness BA, Judson BL, Mehra S, Edwards HA, Yarbrough WG, Peter PR, Holt EH, Decker RH, Husain ZA, Park HS. Adjuvant external beam radiotherapy for surgically resected, nonmetastatic anaplastic thyroid cancer. Head & Neck 2020, 42: 1031-1044. PMID: 32011055, DOI: 10.1002/hed.26086.Peer-Reviewed Original ResearchConceptsAnaplastic thyroid cancerLonger OSAdjuvant EBRTThyroid cancerAdjuvant external beam radiotherapyNational Cancer DatabaseExternal beam radiotherapyConcurrent chemoradiationConcurrent chemotherapyImproved survivalMedian ageCancer DatabaseRetrospective analysisBeam radiotherapyEBRTChemotherapyPatientsCancerUVAChemoradiationResectionRadiotherapy
2019
Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins
Benchetrit L, Torabi SJ, Morse E, Mehra S, Rahmati R, Osborn HA, Judson BL. Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins. The Laryngoscope 2019, 130: 1450-1458. PMID: 31411749, DOI: 10.1002/lary.28224.Peer-Reviewed Original ResearchConceptsPreoperative biopsyParotid malignanciesSurgical marginsPositive marginsClinical T1 stageNational Cancer DatabaseClinical T stageClinical N stageHigh-volume centersSubgroup of patientsMultivariable logistic regressionEarly clinical stageChi-square testAdjuvant therapyRetrospective cohortYounger patientsT stageClinical stageSurgical outcomesVolume centersBiopsy useCancer DatabaseN stageBiopsyPatientsGender 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
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 factorsPositive surgical margins in parotid malignancies: Institutional variation and survival association
Morse E, Fujiwara RJT, Judson B, Prasad ML, Mehra S. Positive surgical margins in parotid malignancies: Institutional variation and survival association. The Laryngoscope 2018, 129: 129-137. PMID: 30194762, DOI: 10.1002/lary.27221.Peer-Reviewed Original ResearchConceptsPositive surgical marginsPositive margin rateOverall survivalSurgical marginsHigh-volume facilitiesMargin ratePositive marginsParotid malignanciesMucoepidermoid carcinomaCox proportional hazards regressionOverall positive margin rateLow-grade mucoepidermoid carcinomaNational Cancer DatabaseProportional hazards regressionMultivariable logistic regressionPositive margin statusRetrospective database analysisParotid cancerMargin statusHazards regressionCancer DatabaseSurvival associationsDecreased oddsCystic carcinomaPatientsNational 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 DatabaseAdjuvant therapy in major salivary gland cancers: Analysis of 8580 patients in the National Cancer Database
Cheraghlou S, Kuo P, Mehra S, Agogo GO, Bhatia A, Husain ZA, Yarbrough WG, Burtness BA, Judson BL. Adjuvant therapy in major salivary gland cancers: Analysis of 8580 patients in the National Cancer Database. Head & Neck 2018, 40: 1343-1355. PMID: 29756412, DOI: 10.1002/hed.24984.Peer-Reviewed Original ResearchConceptsNational Cancer Data BaseLate-stage diseaseAdjuvant treatmentSalivary gland cancerAdverse featuresAdjuvant radiotherapyImproved survivalGland cancerMajor salivary gland cancerAddition of chemotherapyNational Cancer DatabaseAdjuvant therapySurvival benefitRetrospective studyCancer DatabaseImproved outcomesCancer casesPatientsChemotherapyDiseaseTreatmentRadiotherapySurvivalCancerTherapyTreatment Times in Salivary Gland Cancer: National Patterns and Association with Survival
Morse E, Fujiwara RJT, Judson B, Mehra S. Treatment Times in Salivary Gland Cancer: National Patterns and Association with Survival. Otolaryngology 2018, 159: 283-292. PMID: 29460669, DOI: 10.1177/0194599818758020.Peer-Reviewed Original ResearchConceptsOverall survivalSalivary cancerTotal treatment packageMedian durationRT durationTreatment initiationRadiation treatmentTreatment characteristicsMultivariable Cox proportional hazards regressionCox proportional hazards regressionMultivariable binary logistic regressionNational Cancer DatabaseProportional hazards regressionSalivary gland cancerTreatment packageBinary logistic regressionTherapy durationInitial treatmentFacility volumeHazards regressionFourth quartileCare transitionsGland cancerInsurance statusCancer DatabaseSalvage 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
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-MeierDatabase and Registry Research in Thyroid Cancer: Striving for a New and Improved National Thyroid Cancer Database
Mehra S, Tuttle RM, Milas M, Orloff L, Bergman D, Bernet V, Brett E, Cobin R, Doherty G, Judson BL, Klopper J, Lee S, Lupo M, Machac J, Mechanick JI, Randolph G, Ross DS, Smallridge R, Terris D, Tufano R, Alon E, Clain J, DosReis L, Scherl S, Urken ML. Database and Registry Research in Thyroid Cancer: Striving for a New and Improved National Thyroid Cancer Database. Thyroid 2015, 25: 157-168. PMID: 25517683, DOI: 10.1089/thy.2014.0270.Peer-Reviewed Original ResearchConceptsThyroid Cancer Care CollaborativeThyroid cancerCancer RegistryHealth registriesCancer managementPopulation-based cancer registriesDifferentiated thyroid cancerThyroid cancer databaseThyroid cancer managementQuality of careCancer researchSurveillance recommendationsCare CollaborativeOptimal treatmentCancer DatabaseRegistry researchDisease RegistryRegistryPatient carePhysician workflowCancerSpecific patientClinical researchCurrent registryDifferent treatment sites
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 Database