Publications by authors named "Catherine T Haring"

Objectives: Large language model (LLM)-based chatbots such as ChatGPT have been publicly available and increasingly utilized by the general public since late 2022. This study sought to investigate ChatGPT responses to common patient questions regarding Human Papilloma Virus (HPV) positive oropharyngeal cancer (OPC).

Methods: This was a prospective, multi-institutional study, with data collected from high volume institutions that perform >50 transoral robotic surgery cases per year.

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The osteocutaneous radial forearm (OCRFF) is a versatile free flap option for bony defects of the head and neck, given the thinness and pliability of the forearm cutaneous paddle, pedicle length, reliability, lack of atherosclerosis, and functional concerns common to other osseous donor sites. The OCRFF was once associated with a high risk of radial fracture, in addition to concerns about the quality and durability of bone stock for osseous reconstruction, particularly for the mandible. Following the introduction of prophylactic plating of the radius, the incidence of symptomatic radial fracture has drastically decreased.

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Purpose: Patients undergoing head and neck cancer surgery after prior radiation or chemoradiation are at high risk for wound complications. Hypothyroidism is a known risk factor for wound complications, especially fistulae after salvage total laryngectomy. The purpose of this phase II clinical trial is to investigate the effect of perioperative intravenous levothyroxine supplementation on wound complications in patients undergoing salvage total laryngectomy.

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The osteocutaneous radial forearm free flap (OCRFFF) is a versatile flap with the ability to reconstruct complex defects. We detail the techniques necessary to harvest an OCRFFF, including an outline on making 90-degree osteotomies to maximize bone harvest. In this pictorial essay, we provide illustrations of the anatomy and surgical techniques necessary for OCRFFF harvest.

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Article Synopsis
  • * A study of 15 nonmetastatic AR+ SDC patients revealed that a significant portion had advanced disease at diagnosis, and those treated with a combination of surgery, radiation, and systemic therapy showed promising outcomes with a 5-year overall survival rate of 87%.
  • * There is considerable variation in immunoprofiles like HER-2 expression among these tumors, suggesting that personalized treatment strategies, including targeted therapies, could improve patient outcomes in the future.
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  • - This study explored how preoperative thyroid hormone replacement affects complications in patients undergoing major abdominal surgery over a decade at an academic institution.
  • - Among 2,700 patients, those on thyroid replacement had a significantly higher risk (1.5 times) of serious complications and longer hospital stays, along with an increased likelihood of undergoing open surgery.
  • - The findings suggest that thyroid hormone replacement is an important factor to consider when evaluating surgical risks, as it is linked to greater morbidity and extended recovery times.
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Importance: As the incidence of oropharyngeal squamous cell carcinoma (OPSCC) continues to rise in the US, an increasing number of patients are being treated with transoral robotic surgery (TORS). Readmission following surgery can potentially delay initiation of adjuvant treatment and affect survival outcomes.

Objective: To identify risk factors for 30-day postoperative readmission in patients undergoing TORS for OPSCC.

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Importance: Historical data reveal that, compared with women, men are more likely to pursue a head and neck surgical oncology fellowship, but little is known about possible gender differences in academic productivity.

Objective: To assess demographic trends and academic productivity among American Head & Neck Society (AHNS) fellowship graduates.

Design, Setting, And Participants: This cross-sectional study used electronically published data from the AHNS on fellowship graduates in the US and Canada from July 1, 1997, to June 30, 2022.

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Circulating tumor DNA (ctDNA) has become an area of intense study in many solid malignancies including head and neck cancer. This is of particular interest for human papillomavirus-mediated oropharyngeal squamous cell carcinoma as this cohort of patients has excellent survival and is undergoing current clinical trials aimed at treatment de-escalation. Recent studies have demonstrated the prognostic implications of pretreatment ctDNA and the utility of monitoring ctDNA during and posttreatment; however, there is a need for a more critical understanding of ctDNA as it is beginning to be incorporated into clinical trials.

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Objectives: To develop a high-performance droplet digital PCR (ddPCR) assay capable of enhancing the detection of human papillomavirus (HPV) circulating tumor DNA (ctDNA) in plasma from patients with HPV-associated oropharyngeal squamous cell carcinoma (HPV+ OPSCC).

Materials And Methods: Plasma samples from subjects with HPV+ OPSCC were collected. We developed a high-performance ddPCR assay designed to simultaneously target nine regions of the HPV16 genome.

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Article Synopsis
  • A study analyzed patterns of recurrence and survival in patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) from 1998 to 2019, involving 447 patients.!
  • Median overall survival improved from 6.7 months (1998-2007) to 11.8 months (2008-2019), with factors like HPV negativity and poor performance status linked to worse outcomes.!
  • The findings support the importance of early detection for recurrence and suggest that understanding these patterns can help develop personalized follow-up care and guide clinical trial eligibility.
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Objectives: This study investigates the impact of immediate resection of positive margins on local control of oral tongue cancer.

Materials And Methods: We analyzed 273 consecutive oral tongue cancers resected from 2013 to 2018. Additional resection was performed in cases during the initial operation based on surgeon inspection of the specimen and/or frozen margins.

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Objectives: To define the role of hypothyroidism and other risk factors for unplanned readmissions after surgery for head and neck cancer.

Study Design: Retrospective cohort study.

Methods: The Nationwide Readmission Database (NRD) was used to identify patients who underwent surgery for mucosal head and neck cancer (oral cavity, oropharynx, larynx, and hypopharynx) between 2010 and 2017.

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Objectives: Examine the relationship between hospital volume and overall mortality in a surgical cohort of head and neck squamous cell carcinoma (HNSCC) patients.

Materials & Methods: A retrospective review of the NCDB was completed for adults with previously untreated HNSCC diagnosed between 2004 and 2016. Mean annual hospital volume was calculated using the number of head and neck cancer cases treated at a given facility divided by the number of years the facility reported to the NCDB.

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Background: Oral cavity cancer (OCC) is traditionally associated with smoking, but there is an increasing prevalence of the disease among non-smokers. This review investigates possible modifiable risk factors in the development of OCC in non-smokers (OCCNS).

Methods: PubMed, EMBASE, Web of Science, and Scopus were searched for publications prior to June 2021.

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Article Synopsis
  • Fibula free flaps (FFF) have traditionally been used for mandibular reconstruction, but scapular system free flaps (SFF) are gaining traction due to their versatility and fewer complications at the donor site.
  • A study reviewed 176 patients who underwent either FFF or SFF reconstructions; operative times were similar, but SFF showed less donor site morbidity.
  • The results indicate that SFF could be a preferred choice for complex mandibular defects, thanks to its quicker harvesting process and reduced complications compared to FFF.
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Human papillomavirus (HPV) related oropharyngeal squamous cell carcinoma (OPSCC) is associated with improved outcomes compared to non-virally mediated disease. Clinical trials are actively investigating de-escalation strategies to maintain excellent survival outcomes while minimizing toxicity. Delivery of effective precision medicine-based therapeutic approaches are strengthened by the identification of biomarkers to predict treatment response.

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Purpose: In locally advanced p16+ oropharyngeal squamous cell carcinoma (OPSCC), (i) to investigate kinetics of human papillomavirus (HPV) circulating tumor DNA (ctDNA) and association with tumor progression after chemoradiation, and (ii) to compare the predictive value of ctDNA to imaging biomarkers of MRI and FDG-PET.

Experimental Design: Serial blood samples were collected from patients with AJCC8 stage III OPSCC ( = 34) enrolled on a randomized trial: pretreatment; during chemoradiation at weeks 2, 4, and 7; and posttreatment. All patients also had dynamic-contrast-enhanced and diffusion-weighted MRI, as well as FDG-PET scans pre-chemoradiation and week 2 during chemoradiation.

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Objectives: Phosphaturic mesenchymal tumor (PMT) is a rare, polymorphous neoplasm with a highly variable presentation and natural history and unpredictable clinical course. The primary objective was to describe our clinical experience with and management of 4 markedly different cases of sinonasal and skull base PMT.

Methods: A retrospective case series with chart review, and relevant literature review, was performed at a tertiary academic medical center between 1998 and 2020.

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Background: During the last two decades, significant advancements in the treatment of laryngeal cancer have occurred. Although survival of head and neck cancer patients has improved over time, the temporal trend of laryngeal cancer survival is an area of controversy.

Methods: From 2004 to 2016, 77,527 patients who had laryngeal cancer treated with curative intent in the United States were identified in the National Cancer Database.

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Despite the rising incidence of human papillomavirus related (HPV+) oropharyngeal squamous cell carcinoma (OPSCC), treatment of metastatic disease remains palliative. Even with new treatments such as immunotherapy, response rates are low and can be delayed, while even mild tumor progression in the face of an ineffective therapy can lead to rapid death. Real-time biomarkers of response to therapy could improve outcomes by guiding early change of therapy in the metastatic setting.

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