Featured Publications
A 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
Extranodal 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 I
2020
Adjuvant 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
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 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 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
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 factorsHPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes
Cheraghlou S, Torabi SJ, Husain ZA, Otremba MD, Osborn HA, Mehra S, Yarbrough WG, Burtness BA, Judson BL. HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes. The Laryngoscope 2018, 129: 684-691. PMID: 30151832, DOI: 10.1002/lary.27475.Peer-Reviewed Original ResearchConceptsHPV-negative patientsTreatment deintensificationCN3 diseaseHPV statusNeck cancerUnivariate Kaplan-Meier analysisTumor human papillomavirus (HPV) statusCox survival regressionHPV-negative diseaseIdentifiable primary tumorUnknown primary headHPV-positive patientsHuman papillomavirus (HPV) statusTumor HPV statusKaplan-Meier analysisTreatment-related outcomesSignificant prognostic valuePoor patient survivalCases of headDefinitive chemoradiotherapyDefinitive radiotherapyMetastatic nodesNodal classificationUnknown primaryTherapeutic challengeAdjuvant 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 studyNational 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 casesPatientsChemotherapyDiseaseTreatmentRadiotherapySurvivalCancerTherapyUpfront surgery versus definitive chemoradiotherapy in patients with human Papillomavirus-associated oropharyngeal squamous cell cancer
Kelly JR, Park HS, An Y, Yarbrough WG, Contessa JN, Decker R, Mehra S, Judson BL, Burtness B, Husain Z. Upfront surgery versus definitive chemoradiotherapy in patients with human Papillomavirus-associated oropharyngeal squamous cell cancer. Oral Oncology 2018, 79: 64-70. PMID: 29598952, DOI: 10.1016/j.oraloncology.2018.02.017.Peer-Reviewed Original ResearchConceptsNational Cancer DatabasePrimary surgeryOverall survivalAdjuvant chemoradiotherapyDefinitive chemoradiotherapyUpfront surgerySurgical patientsHuman papillomavirus-associated oropharyngeal squamous cell carcinomaOropharyngeal squamous cell carcinomaPropensity score-matched analysisOropharyngeal squamous cell cancerCox proportional hazards regressionMultivariable Cox regressionNon-private insuranceInferior overall survivalMargin-negative resectionSquamous cell cancerProportional hazards regressionSquamous cell carcinomaLog-rank testChi-square testClinicopathologic predictorsSimilar OSSurgery patientsTrimodal therapyTreatment 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
2017
Treatment deintensification in human papillomavirus‐positive oropharynx cancer: Outcomes from the National Cancer Data Base
Cheraghlou S, Yu PK, Otremba MD, Park HS, Bhatia A, Zogg CK, Mehra S, Yarbrough WG, Judson BL. Treatment deintensification in human papillomavirus‐positive oropharynx cancer: Outcomes from the National Cancer Data Base. Cancer 2017, 124: 717-726. PMID: 29243245, DOI: 10.1002/cncr.31104.Peer-Reviewed Original ResearchConceptsNational Cancer Data BaseStage III diseaseTriple-modality therapyAdjuvant radiotherapyOropharyngeal cancerStage IHuman papillomavirus-positive oropharyngeal cancerUnivariate Kaplan-Meier analysisAvoidance of chemotherapyDeintensification of treatmentEdition stage IStage II diseaseMultivariate Cox regressionAmerican Joint CommitteeKaplan-Meier analysisDisease stage groupsForm of treatmentTreatment deintensificationAdjuvant chemoradiotherapyDefinitive radiotherapyTreatment intensificationFavorable prognosisImproved survivalCox regressionRetrospective studyOutcomes and reliability of the flow coupler in postoperative monitoring of head and neck free flaps
Fujiwara RJT, Dibble JM, Larson SV, Pierce ML, Mehra S. Outcomes and reliability of the flow coupler in postoperative monitoring of head and neck free flaps. The Laryngoscope 2017, 128: 812-817. PMID: 28988465, DOI: 10.1002/lary.26944.Peer-Reviewed Original ResearchAdultAgedAged, 80 and overFalse Positive ReactionsFemaleFree Tissue FlapsGraft SurvivalHead and Neck NeoplasmsHumansLogistic ModelsMaleMiddle AgedMonitoring, PhysiologicMouth NeoplasmsPlastic Surgery ProceduresPostoperative ComplicationsPostoperative PeriodReproducibility of ResultsRetrospective StudiesRheologySensitivity and SpecificityVenous ThrombosisYoung AdultUntreated oral cavity cancer: Long‐term survival and factors associated with treatment refusal
Cheraghlou S, Kuo P, Mehra S, Yarbrough WG, Judson BL. Untreated oral cavity cancer: Long‐term survival and factors associated with treatment refusal. The Laryngoscope 2017, 128: 664-669. PMID: 28865100, DOI: 10.1002/lary.26809.Peer-Reviewed Original ResearchConceptsOral cavity cancerNatural courseTreatment refusalUnivariate Kaplan-Meier analysisFive-year survival rateFacility case volumeNational Cancer DatabaseStage 4 patientsExtent of diseaseMultivariate Cox regressionEarly-stage patientsKaplan-Meier analysisNumber of patientsCommon malignant diseaseLong-term survivalInitial treatment planningAdvanced diseaseUntreated patientsAdult patientsRetrospective reviewCox regressionPatient's likelihoodPoor prognosisInsurance statusMalignant diseaseTreatment 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 ResearchConceptsOral 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 regression