Clinical and Pathologic Characteristics of Cytologically Indeterminate Thyroid Nodules with Non-V600E Alterations.

Background: Molecular assays serve as a potential risk stratification tool for cytologically indeterminate thyroid nodules (ITNs). mutations are nearly always associated with thyroid cancer. However, the malignancy risk for ITNs with other less common alterations is less well understood.

Active Surveillance for Pleomorphic Adenomas of the Parotid-Tumor Growth Rate, Potential Malignancy, and Surgical Sequalae.

Objective: The outcomes of active surveillance (AS) for pleomorphic adenomas (PA) as an alternative to upfront parotidectomy have not been previously documented in the literature. This cohort study aims to assess the safety and feasibility of AS for parotid gland PA.

Methods: All patients with of previously untreated PA managed between 1990 and 2015 were reviewed.

-Mutated Cytologically Indeterminate Thyroid Nodules: Prevalence of Malignancy and Behavior Under Active Surveillance.

Genomic profiling is now available for risk stratification of cytologically indeterminate thyroid nodules (ITNs). Mutations in genes (, , ) are found in both benign and malignant thyroid nodules, although isolated mutations are rarely associated with aggressive tumors. Because the long-term behavior of -mutant ITNs is not well understood, most undergo immediate surgery.

Higher Rates of Inadequate Adjuvant Radiation Dose Among Older Adults with Head and Neck Cancer.

Objective: To determine the rate of inadequate radiotherapy and identify risk factors associated with inadequate adjuvant radiotherapy for head and neck cancer among older adults.

Methods: A retrospective review of the National Cancer Database (NCDB) was performed to identify patients diagnosed with squamous cell cancer of the head and neck between 2004 and 2017. Patients with a single malignancy, negative surgical margins, no extranodal extension, and receipt of adjuvant radiation without systemic therapy were included in the study cohort.

Adjuvant Radiotherapy in Moderately Advanced (T3) Oral Cavity Cancers.

Objective: To investigate the impact of adjuvant radiotherapy in isolated locally advanced oral cavity cancers (pT3N0M0) without adverse features.

Methods: We selected all patients from the National Cancer Database (2004-2019) who underwent surgical treatment where the final pathology was T3N0M0 with negative margins. Demographics, details of treatment, and outcomes were abstracted.

Risk of Carcinoma in Pleomorphic Adenomas of the Parotid.

Importance: Surgery is the mainstay of treatment for pleomorphic adenomas (PAs) of the parotid to prevent further growth and potential future malignant transformation. While historical case series have reported transformation rates as high as 10%, there is a lack of contemporary methodologically sound data.

Objective: To examine the rate of carcinoma ex pleomorphic adenoma (CXPA) detection in untreated PAs and investigate factors associated with malignant neoplasm.

Pathologic Features, Treatment, and Clinical Outcomes of Lacrimal Gland Cancer.

Objectives: Lacrimal gland cancer is a rare malignancy with little data known about its pathologic characteristics or optimal management. We performed a large database analysis using the National Cancer Database (NCDB) to elucidate this unusual condition.

Methods: Patients with lacrimal gland cancer diagnosed between 2004 and 2018 were included in the analysis.

Virtual Tumor Boards for Remote Learning in Head and Neck Surgical Oncology.

Importance: In addition to their patient management value, multidisciplinary tumor boards have been recognized as effective learning tools. However, the value of using a virtual tumor board as a learning tool for head and neck surgical oncology fellows has not been studied.

Objective: To describe the structure and content of the American Head and Neck Society (AHNS) Virtual Tumor Board and assess its educational value as perceived by attendees.

The RVU Compensation Model and Head and Neck Surgical Education.

Background: The present study aims to quantify the opportunity cost of training residents and fellows for head and neck surgery.

Methods: A 2005-2015 review of ablative head and neck surgical procedures was performed using the National Surgical Quality Improvement Program (NSQIP). Work relative value units (wRVU) generated per hour were compared among procedures performed by attendings alone, attendings with residents, and attendings with fellows.

Surgical Treatment in Very Advanced (T4b) Adenoid Cystic Carcinoma of the Head and Neck.

Objective: To compare treatment outcomes for T4b head and neck adenoid cystic carcinoma (ACC).

Study Design: Historical cohort study.

Setting: National Cancer Database (NCDB).

Private Payer-Negotiated Rates for FDA-Approved Head and Neck Cancer Immunotherapy and Chemotherapy Agents.

Objective: To quantify the price that private payers pay hospitals for head and neck squamous cell carcinoma (HNSCC) treatments and identify hospital-level factors associated with price variation.

Study Design: Cross-sectional study.

Setting: Price transparency files.

American Thyroid Association Guidelines and National Trends in Management of Papillary Thyroid Carcinoma.

Importance: Over time, the American Thyroid Association (ATA) guidelines have increasingly promoted more limited treatments for well-differentiated thyroid cancers.

Objective: To determine whether the 2009 and 2015 ATA guidelines were associated with changes in the management of low-risk papillary thyroid carcinomas on a national scale.

Design, Setting, And Participants: This historical cohort study used the National Cancer Database.

Adoption of adjuvant chemotherapy in high-risk salivary gland malignancies.

Background: The present study characterizes national trends in the utilization of adjuvant chemotherapy to treat salivary gland malignancies.

Methods: The National Cancer Database was queried for salivary gland malignancies treated by surgery with radiation in 2004-2019. Proportions of patients receiving adjuvant chemotherapy over the study period were analyzed by linear regression.

Patterns of Care and Outcomes of Carcinosarcoma of the Major Salivary Glands.

Objective: Carcinosarcoma of the salivary gland is a rare malignant biphasic tumor. The present study investigates the epidemiology and clinical behavior of carcinosarcoma of the major salivary glands using the National Cancer Database (NCDB).

Study Design: Historical cohort study.

Distribution of the head and neck surgical oncology workforce in the United States.

Background: The recent trends in education and geographic distribution of the head and neck surgery workforce have not been studied extensively.

Methods: We reviewed publicly available sources to locate all fellowship-trained head and neck surgeons and recent graduates. The number of surgeons in each state was compared against head and neck cancer incidence data from the Centers for Disease Control.

Needs assessment in head and neck surgical oncology training: A qualitative study of expert opinions.

Background: Few studies have investigated the needs of head and neck surgery trainees and areas for improvement of fellowship programs.

Methods: We conducted a qualitative study by interviewing a nationally representative sample of program directors and national leaders in head and neck surgery. We asked about the current state and strengths of training; and areas for further improvement.

Minor Salivary Gland Biopsy in Diagnosis of Sjögren's Syndrome.

Objective: Previous studies have questioned the safety and efficacy of minor salivary gland biopsy in the diagnosis of Sjögren's syndrome, citing complications and difficulty of pathologic evaluation. This study aims to determine the rate of biopsy specimen adequacy and the risk of complications after minor salivary gland biopsy.

Study Design: Case series.

Sinonasal Undifferentiated Carcinoma with Failed Response to Induction Chemotherapy.

Sinonasal undifferentiated carcinoma (SNUC) is a rapidly growing malignancy with a propensity for extensive local invasion. Multimodal therapy, including surgery, radiotherapy, and chemotherapy, is the standard approach to treatment, but the optimal sequence and combination of these modalities are uncertain. Induction chemotherapy is being increasingly utilized based on recent reports that show better outcomes for patients who respond to chemotherapy and the ability to determine further course of treatment.

Sinonasal Glomangiopericytoma with Prolonged Postsurgical Follow-Up.

Sinonasal glomangiopericytoma is a rare vascular tumor of the respiratory epithelium. Treatment consists mainly of surgical resection, though there is no consensus regarding the use of adjuvant therapies or preoperative endovascular embolization. The postsurgical prognosis is favorable, though there is a high risk of delayed recurrence.

Nodal Metastases in Pediatric and Adult Acinic Cell Carcinoma of the Major Salivary Glands.

Objective: Acinic cell carcinoma (AciCC) is a rare, usually low-grade salivary malignancy. Evidence on rates of lymph node metastases (LNMs) is limited in pediatric patients and varies significantly (4%-45%) in adults. We set out to determine and compare rates of LNMs in pediatric and adult AciCC and to analyze their impact on survival, using the National Cancer Database.