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 modelsClinical 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 therapy
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 margins
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 studyPediatric Salivary Cancer: Epidemiology, Treatment Trends, and Association of Treatment Modality with Survival
Morse E, Fujiwara RJT, Husain Z, Judson B, Mehra S. Pediatric Salivary Cancer: Epidemiology, Treatment Trends, and Association of Treatment Modality with Survival. Otolaryngology 2018, 159: 553-563. PMID: 29688836, DOI: 10.1177/0194599818771926.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentBiopsy, NeedleCarcinoma, MucoepidermoidChemotherapy, AdjuvantChildChild, PreschoolCombined Modality TherapyCross-Sectional StudiesDatabases, FactualFemaleHumansImmunohistochemistryLogistic ModelsMaleMultivariate AnalysisNeoplasm InvasivenessNeoplasm StagingPrognosisProportional Hazards ModelsRadiotherapy, AdjuvantRetrospective StudiesSalivary Gland NeoplasmsSurvival AnalysisTreatment OutcomeConceptsImproved overall survivalOverall survivalHigh tumor gradeTreatment modalitiesTumor gradeSalivary cancerAdjuvant radiationMultivariable Cox proportional hazards regressionNational Cancer Database 2004Cox proportional hazards regressionTreatment factorsPatients 19 yearsHigh-risk patientsSubset of patientsMultivariable logistic regressionProportional hazards regressionUS national databaseHigh-grade tumorsSalivary gland cancerAcinar cell carcinomaPediatric patientsTumor characteristicsHazards regressionCell carcinomaGland cancerTreatment 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-MeierTreatment Factors Associated With Survival in Early-Stage Oral Cavity Cancer: Analysis of 6830 Cases From the National Cancer Data Base
Luryi AL, Chen MM, Mehra S, Roman SA, Sosa JA, Judson BL. Treatment Factors Associated With Survival in Early-Stage Oral Cavity Cancer: Analysis of 6830 Cases From the National Cancer Data Base. JAMA Otolaryngology - Head & Neck Surgery 2015, 141: 593-598. PMID: 25974757, DOI: 10.1001/jamaoto.2015.0719.Peer-Reviewed Original ResearchConceptsOral cavity squamous cell cancerNational Cancer Data BaseNeck dissectionOverall survivalImproved survivalRadiation therapyTreatment factorsMultivariable analysisPositive marginsStage IEarly-stage oral cavity cancerOral cavity squamous cell carcinomaElimination of patientsTumor prognostic featuresAdjuvant radiation therapyOccult nodal diseaseOral cavity cancerSquamous cell cancerSquamous cell carcinomaPopulation-level dataAdjuvant chemotherapyPathologic restagingNodal diseaseMost patientsPrognostic impact
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 DatabaseSubscapular system of flaps: An 8‐year experience with 105 patients
Gibber MJ, Clain JB, Jacobson AS, Buchbinder D, Scherl S, Zevallos JP, Mehra S, Urken ML. Subscapular system of flaps: An 8‐year experience with 105 patients. Head & Neck 2014, 37: 1200-1206. PMID: 24800735, DOI: 10.1002/hed.23738.Peer-Reviewed Original ResearchConceptsSubscapular systemFree flapRetrospective medical chart reviewExtensive surgical defectsMedical chart reviewOverall success rateDonor siteSoft tissue componentSoft tissue elementsLarge muscle flapsChart reviewEarly mobilizationAlternative donor siteMuscle flapAdvanced agePatientsNeck reconstructionSurgical defectsVital structuresFirst choiceMaxillary defectsFlapMandibular defectsSuccess rateNoninvasive 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 tumorsPatientsTranstracheal approach to repair of a tracheo‐colonic fistula 44 years after colonic interposition
Mehra S, Scherl S, Lazarus C, Dewey E, Urken ML. Transtracheal approach to repair of a tracheo‐colonic fistula 44 years after colonic interposition. Head & Neck 2014, 36: e117-e120. PMID: 24375707, DOI: 10.1002/hed.23586.Peer-Reviewed Original ResearchConceptsTranstracheal approachColonic interpositionTraditional lateral approachSternocleidomastoid muscle flapTracheoesophageal fistula repairPrior esophagectomyUneventful recoveryRare pathologyCase reportFistula repairMuscle flapPrimary closureLateral approachDirect repairColon mucosaFistulaAlimentary tractPatientsInterpositionTracheaRepairEffective reconstitution
2012
Cervical metastasis of germ cell tumors: Evaluation, management, complications, and outcomes
Mehra S, Liu J, Gupta A, Sheinfeld J, Kraus D. Cervical metastasis of germ cell tumors: Evaluation, management, complications, and outcomes. The Laryngoscope 2012, 122: 286-290. PMID: 22252920, DOI: 10.1002/lary.22422.Peer-Reviewed Original ResearchConceptsDisease-specific survivalRetrospective chart reviewNeck massChart reviewConsecutive patientsInitial diagnosisSingle-institution retrospective chart reviewDiagnosis of GCTResidual neck massesPercent of patientsSecondary end pointsPreoperative tumor markersPermanent nerve injuryGerm cell tumorsCervical controlMetastatic GCTNeck recurrenceCervical metastasisPositive nodesPresenting symptomChyle leakNerve injuryTumor metastaticLimited complicationsOperative management
2009
Endoscopic endonasal repair of anterior skull base non-traumatic cerebrospinal fluid leaks, meningoceles, and encephaloceles.
Nyquist GG, Anand VK, Mehra S, Kacker A, Schwartz TH. Endoscopic endonasal repair of anterior skull base non-traumatic cerebrospinal fluid leaks, meningoceles, and encephaloceles. Journal Of Neurosurgery 2009, 113: 961-6. PMID: 19929192, DOI: 10.3171/2009.10.jns08986.Peer-Reviewed Original ResearchConceptsEndoscopic endonasal repairAnterior skull baseEndoscopic endonasal approachCSF leakEndonasal repairCribriform plateEndonasal approachFrontal sinusSkull baseClosure rateAverage body mass indexProspective observational studyBody mass indexCerebrospinal fluid leakLateral sphenoid sinusSkull base defectsEndoscopic seriesPostoperative debridementPerioperative treatmentConsecutive patientsPatient characteristicsEncephalocele repairMass indexFemale sexEndoscopic repair