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 therapyA Clinical Care Pathway to Reduce ICU Usage in Head and Neck Microvascular Reconstruction
Morse E, Henderson C, Carafeno T, Dibble J, Longley P, Chan E, Judson B, Yarbrough WG, Sasaki C, Mehra S. A Clinical Care Pathway to Reduce ICU Usage in Head and Neck Microvascular Reconstruction. Otolaryngology 2018, 160: 783-790. PMID: 30060705, DOI: 10.1177/0194599818782404.Peer-Reviewed Original ResearchConceptsClinical care pathwayLength of stayReadmission ratesFree flap patientsCare pathwayICU admissionSurgical complicationsFlap patientsIntensive care unit admissionNeck free flap patientsRoutine ICU admissionCare unit admissionNumber of patientsNeck microvascular reconstructionFree tissue transferReconstruction of headPrepathway groupUnit admissionPostoperative complicationsPostoperative lengthVentilatory supportMedical complicationsMedian lengthPatient populationPathway implementation
2021
The impact of a double vein anastomoses on doppler's loss of signal rates
Cohen O, Morse E, Fujiwara RJT, Dibble J, Pierce M, Mehra S. The impact of a double vein anastomoses on doppler's loss of signal rates. European Journal Of Surgical Oncology 2021, 48: 27-31. PMID: 34610861, DOI: 10.1016/j.ejso.2021.09.021.Peer-Reviewed Original ResearchExtranodal 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 IA 2020 Update on Public Awareness of Head and Neck Cancers
Torabi SJ, Kasle DA, Su-Velez B, Mehra S, Day TA, Yarbrough WG, St. John M, Judson BL. A 2020 Update on Public Awareness of Head and Neck Cancers. Otolaryngology 2021, 166: 305-312. PMID: 33845657, DOI: 10.1177/01945998211006932.Peer-Reviewed Original ResearchConceptsHuman papillomavirusHPV's roleNeck cancerNeck Cancer Awareness WeekKnowledge of HNCSigns/symptomsFormer tobacco usersCross-sectional surveyFormer smokersOropharyngeal cancerRisk factorsTobacco usersElderly individualsRisk populationsAwareness rateUS populationOlder individualsFuture outreach effortsCancerCausal roleHNCAwareness WeekUS CensusExposureHead
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 databaseAssessing 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 approach
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 reviewPreoperative 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 stageBiopsyPatientsEpidemiological analysis of croup in the emergency department using two national datasets
Hanna J, Brauer PR, Morse E, Berson E, Mehra S. Epidemiological analysis of croup in the emergency department using two national datasets. International Journal Of Pediatric Otorhinolaryngology 2019, 126: 109641. PMID: 31442871, DOI: 10.1016/j.ijporl.2019.109641.Peer-Reviewed Original ResearchConceptsEmergency Department SampleEmergency departmentReadmission ratesNational Hospital Ambulatory Medical Care SurveyAmbulatory Medical Care SurveyNational Emergency Department SampleNationwide Emergency Department SampleCases of croupHospital admission ratesInappropriate antibiotic useIncidence of croupMajority of casesRepeat admissionsSteroid usageHospital admissionAirway proceduresAnnual incidenceRetrospective reviewMean agePeak incidenceCare SurveyAdmission ratesAntibiotic useAntibiotic usageAverage ageIs 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 marginsPositive Surgical Margins in Submandibular Malignancies: Facility and Practice Variation
Benchetrit L, Morse E, Judson BL, Mehra S. Positive Surgical Margins in Submandibular Malignancies: Facility and Practice Variation. Otolaryngology 2019, 161: 620-628. PMID: 31159649, DOI: 10.1177/0194599819852094.Peer-Reviewed Original ResearchConceptsPositive margin ratePositive surgical marginsPositive marginsOverall survivalMargin rateSurgical resectionSurgical marginsSubmandibular carcinomaCox proportional hazards regressionMultivariable logistic regression analysisCancer-accredited hospitalsPreoperative diagnostic biopsiesNational Cancer DatabasePrimary surgical resectionAdvanced T stageKaplan-Meier curvesProportional hazards regressionLogistic regression analysisQuality of careCarcinoma histologyRetrospective cohortMargin statusPreoperative biopsyT stageHazards regressionPathologic 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
Adult epiglottitis: Trends and predictors of mortality in over 30 thousand cases from 2007 to 2014
Hanna J, Brauer PR, Berson E, Mehra S. Adult epiglottitis: Trends and predictors of mortality in over 30 thousand cases from 2007 to 2014. The Laryngoscope 2018, 129: 1107-1112. PMID: 30582183, DOI: 10.1002/lary.27741.Peer-Reviewed Original ResearchConceptsPredictors of mortalityEmergency departmentAdult epiglottitisPatient ageMultivariate analysisNational Emergency Department SampleStudy periodAverage patient ageEmergency Department SampleOverall mean ageLower ratesAirway interventionClinical factorsAirway proceduresSmoking statusInpatient studyMean ageAirway visualizationUnivariate analysisSignificant pathologyMortality riskEpiglottitisPatient encountersClinical interventionsMortalityIndustry Payments to Physicians and Prescriptions of Brand‐Name Proton‐Pump Inhibitors
Morse E, Fujiwara RJT, Mehra S. Industry Payments to Physicians and Prescriptions of Brand‐Name Proton‐Pump Inhibitors. Otolaryngology 2018, 160: 70-76. PMID: 30325706, DOI: 10.1177/0194599818803337.Peer-Reviewed Original ResearchHypopharyngeal 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 factors