Featured Publications
Changes 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 models
2020
Assessing 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 ResearchMeSH KeywordsAgedChemotherapy, AdjuvantHumansRadiotherapy, AdjuvantRetrospective StudiesThyroid Carcinoma, AnaplasticThyroid NeoplasmsConceptsAnaplastic thyroid cancerLonger OSAdjuvant EBRTThyroid cancerAdjuvant external beam radiotherapyNational Cancer DatabaseExternal beam radiotherapyConcurrent chemoradiationConcurrent chemotherapyImproved survivalMedian ageCancer DatabaseRetrospective analysisBeam radiotherapyEBRTChemotherapyPatientsCancerUVAChemoradiationResectionRadiotherapy
2016
Active Surveillance for Papillary Thyroid Microcarcinoma: New Challenges and Opportunities for The Health Care System
Haser GC, Tuttle RM, Su HK, Alon EE, Bergman D, Bernet V, Brett E, Cobin R, Dewey EH, Doherty G, Dos Reis LL, Harris J, Klopper J, Lee SL, Levine RA, Lepore SJ, Likhterov I, Lupo MA, Machac J, Mechanick JI, Mehra S, Milas M, Orloff LA, Randolph G, Revenson TA, Roberts KJ, Ross DS, Rowe ME, Smallridge RC, Terris D, Tufano RP, Urken ML. Active Surveillance for Papillary Thyroid Microcarcinoma: New Challenges and Opportunities for The Health Care System. Endocrine Practice 2016, 22: 602-611. PMID: 26799628, PMCID: PMC5539410, DOI: 10.4158/ep151065.ra.Peer-Reviewed Original ResearchConceptsPapillary thyroid microcarcinomaThyroid Cancer Care CollaborativeActive surveillancePapillary thyroid carcinomaQuality of lifeClinical statusThyroid microcarcinomaMobile patient populationActive surveillance protocolsPatient's clinical statusActive surveillance studyEducation of patientsProper patient selectionSafe management strategyHealth care systemSelect patientsNonsurgical managementPatient selectionPatient populationSmall cancersCare CollaborativeSurveillance protocolEarly diagnosisPatient supportThyroid carcinoma
2015
Response to “Breach of the thyroid capsule and lymph node capsule in node-positive papillary and medullary thyroid cancer: Different biology”
Rowe ME, Clain JB, Scherl S, Dos Reis L, Turk A, Wenig BM, Mehra S, Urken ML. Response to “Breach of the thyroid capsule and lymph node capsule in node-positive papillary and medullary thyroid cancer: Different biology”. European Journal Of Surgical Oncology 2015, 42: 156-157. PMID: 26632081, DOI: 10.1016/j.ejso.2015.09.029.Peer-Reviewed Original ResearchDatabase 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 ResearchMeSH KeywordsDatabases, FactualEpidemiological MonitoringHumansIncidenceRegistriesResearchThyroid NeoplasmsConceptsThyroid 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
Intrathyroidal Tumors Presenting with Extranodal Extension: What Are We Missing?
Clain JB, Mehra S, Scherl S, Dos Reis LL, Turk A, Wenig BM, Dewey EH, Urken ML. Intrathyroidal Tumors Presenting with Extranodal Extension: What Are We Missing? Endocrine Pathology 2014, 25: 385-389. PMID: 25325929, DOI: 10.1007/s12022-014-9340-9.Peer-Reviewed Original ResearchConceptsExtranodal extensionHistologic featuresIntrathyroidal tumorsLymphovascular invasionPerineural invasionLymphocytic thyroiditisLymph nodesPrimary tumorPsammoma bodiesNode-positive patientsPositive lymph nodesSubset of patientsFischer's exact testGroup A/BMann-Whitney testIntrathyroidal diseaseAggressive biologyPathologic featuresPoor prognosisTumor sizeThyroid cancerAggressive phenotypeExact testTumorsPatientsWhat Is the Gold Standard for Comprehensive Interinstitutional Communication of Perioperative Information for Thyroid Cancer Patients? A Comparison of Existing Electronic Health Records with the Current American Thyroid Association Recommendations
Dos Reis LL, Tuttle RM, Alon E, Bergman DA, Bernet V, Brett EM, Cobin R, Doherty G, Harris JR, Klopper J, Lee SL, Lupo M, Milas M, Machac J, Mechanick JI, Orloff L, Randolph G, Ross DS, Smallridge RC, Terris DJ, Tufano RP, Mehra S, Scherl S, Clain JB, Urken ML. What Is the Gold Standard for Comprehensive Interinstitutional Communication of Perioperative Information for Thyroid Cancer Patients? A Comparison of Existing Electronic Health Records with the Current American Thyroid Association Recommendations. Thyroid 2014, 24: 1466-1472. PMID: 25036190, DOI: 10.1089/thy.2014.0209.Peer-Reviewed Original ResearchConceptsThyroid Cancer Care CollaborativeAmerican Thyroid AssociationMemorial Sloan-Kettering Cancer CenterElectronic health recordsThyroid cancerPerioperative informationPatient informationAmerican Thyroid Association recommendationsCommon electronic health recordThyroid cancer surgeryIntraoperative fieldHealth recordsManagement of patientsThyroid cancer patientsAvailable electronic health recordsRelevant clinical informationElectronic reporting systemPostoperative coursePathologic assessmentCancer surgerySurgical managementCancer CenterCancer patientsCare CollaborativeThyroid AssociationNoninvasive Anaplastic Thyroid Carcinoma: Report of a Case and Literature Review
Dibelius G, Mehra S, Clain JB, Urken ML, Wenig BM. Noninvasive Anaplastic Thyroid Carcinoma: Report of a Case and Literature Review. Thyroid 2014, 24: 1319-1324. PMID: 24865498, DOI: 10.1089/thy.2013.0586.Peer-Reviewed Original ResearchConceptsAnaplastic thyroid carcinomaPositron emission tomography/American Thyroid Association guidelinesFine-needle aspiration biopsyManagement of patientsSeparate disease entityEmission tomography/Evidence of invasionSimilar casesUncommon thyroid malignancyAdjuvant therapyTotal thyroidectomyDistant metastasisFavorable prognosisPreoperative imagingTomography/Disease freeImmunohistochemical evaluationAssociation guidelinesDisease entityThyroid malignancyThyroid carcinomaAspiration biopsyThyroid tumorsPatientsThe Effect of Surgeon Experience on the Detection of Metastatic Lymph Nodes in the Central Compartment and the Pathologic Features of Clinically Unapparent Metastatic Lymph Nodes: What Are We Missing When We Don't Perform a Prophylactic Dissection of Central Compartment Lymph Nodes in Papillary Thyroid Cancer?
Scherl S, Mehra S, Clain J, Dos Reis LL, Persky M, Turk A, Wenig B, Husaini H, Urken ML. The Effect of Surgeon Experience on the Detection of Metastatic Lymph Nodes in the Central Compartment and the Pathologic Features of Clinically Unapparent Metastatic Lymph Nodes: What Are We Missing When We Don't Perform a Prophylactic Dissection of Central Compartment Lymph Nodes in Papillary Thyroid Cancer? Thyroid 2014, 24: 1282-1288. PMID: 24787362, DOI: 10.1089/thy.2013.0600.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCarcinomaCarcinoma, PapillaryFalse Negative ReactionsFalse Positive ReactionsFemaleHashimoto DiseaseHumansIntraoperative PeriodLymph NodesLymphatic MetastasisMaleMiddle AgedNeck DissectionProfessional CompetenceRiskSensitivity and SpecificitySurgeonsThyroid Cancer, PapillaryThyroid NeoplasmsThyroidectomyYoung AdultConceptsProphylactic central neck dissectionPapillary thyroid cancerMetastatic lymph nodesExtranodal extensionLymph nodesOccult metastasesPositive nodesSurgeon experienceOccult nodesPathologic featuresThyroid cancerPresence of ENECentral compartment lymph nodesAdverse histologic featuresMultiple positive nodesPositive central nodesSenior surgeon's assessmentCentral neck dissectionFalse-negative casesGroup of surgeonsEvident nodesPreoperative evidenceProphylactic dissectionNeck dissectionRisk stratificationExtrathyroidal Extension Predicts Extranodal Extension in Patients with Positive Lymph Nodes: An Important Association That May Affect Clinical Management
Clain JB, Scherl S, Dos Reis L, Turk A, Wenig BM, Mehra S, Karle WE, Urken ML. Extrathyroidal Extension Predicts Extranodal Extension in Patients with Positive Lymph Nodes: An Important Association That May Affect Clinical Management. Thyroid 2014, 24: 951-957. PMID: 24443878, DOI: 10.1089/thy.2013.0557.Peer-Reviewed Original ResearchMeSH KeywordsHumansLymphatic MetastasisPrognosisRetrospective StudiesThyroid NeoplasmsThyroidectomyThyroxineTriiodothyronineConceptsExtranodal extensionLymph nodesPrimary tumorPresence of ENEAmerican Pathologists (CAP) protocolNode-positive patientsPositive lymph nodesRecurrent lymph nodesUpstaging of patientsMajority of patientsAggressive disease biologyLong-term survivalPresence of extensionCompletion thyroidectomyPositive nodesNodal metastasisRetrospective reviewHistologic featuresClinical managementDisease aggressivenessThyroid cancerT4 casesThyroid carcinomaHigh incidencePatientsImproving 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