Ten-year Thyroid Cancer Incidence in an Integrated Healthcare Delivery System.

Introduction: The incidence of papillary thyroid cancer (PTC) has increased in recent decades, but data from community-based settings are limited. This study characterizes PTC trends in a large, integrated healthcare system over 10 years.

Methods: The annual incidence of PTC (2006-2015) was examined among Kaiser Permanente Northern California adults aged 21 to 84 years using Cancer Registry data, including tumor size and stage.

Risk of Mortality between Untreated and Treated Papillary Thyroid Cancer: A Matched Cohort Analysis.

Objectives: To examine the association between treatment status and mortality risk among patients with papillary thyroid cancer (PTC).

Methods: We identified 3,679 adults with PTC. Thirty-one untreated patients were matched to 155 treated patients.

Understanding the natural history of papillary thyroid cancer: Case series.

Background: Papillary thyroid cancer (PTC) incidence continues to rise. We describe the natural history of untreated PTC patients.

Methods: Retrospective case series of 31 untreated PTC patients.

Posttreatment surveillance PET/CT for HPV-associated oropharyngeal cancer.

Background: Surveillance positron emission tomography-computed tomography (PET/CT) is commonly used for treatment assessment of radiation therapy in head and neck cancer. However, human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV+OPSCC) patients represent a unique subpopulation, for which the utility of surveillance PET/CT has not been well studied.

Methods: In this retrospective chart review comprising 233 HPV+OPSCC patients, we evaluated surveillance PET/CT for diagnostic accuracy, downstream clinical impact, and survival.

Diagnostic Pathway of Oral Cavity Cancer in an Integrated Health Care System.

Context: Survival for patients with oral cavity squamous cell carcinoma (OCSCC) has remained relatively stagnant despite advances in treatment. Few studies have examined why advanced-stage disease is diagnosed in 40% of patients with OCSCC nationally.

Objective: To characterize the diagnostic pathway of OCSCC in an integrated health care system.

The diagnostic pathway of oropharyngeal squamous cell carcinoma in a large U.S. healthcare system.

Objective: To examine the current diagnostic pathway of oropharyngeal squamous cell carcinoma (OPSCC) and identify factors associated with time to diagnosis.

Methods: Retrospective cohort study of patients with OPSCC in an integrated healthcare system from January 1, 2013, to December 31, 2013. Patient demographics, tobacco and alcohol use, chief complaint, tumor stage, human papilloma virus (HPV) status, physician factors (diagnosis, antibiotic prescription, performance of endoscopic exam, biopsy), and time intervals were examined.

Nasopharyngeal Carcinoma Diagnostic Challenge in a Nonendemic Setting: Our Experience with 101 Patients.

Introduction: We studied the presenting symptoms, time intervals, and workup involved in the diagnosis of nasopharyngeal carcinoma in an integrated health care system.

Methods: A retrospective chart review of all patients with a nasopharyngeal carcinoma diagnosis between 2007 and 2010 at Kaiser Permanente Northern California. Main outcome measures included diagnostic time intervals, presenting symptoms, diagnostic accuracy of nasal endoscopy, imaging, and diagnosis at first otolaryngologist (Oto-HNS) visit.

Surgeon Volume in Parathyroid Surgery-Surgical Efficiency, Outcomes, and Utilization.

This study examines the association between surgeon volume and 30-day rates of complications, mortality, and postdischarge utilization among patients undergoing parathyroidectomy.

Surgeon volume in thyroid surgery: Surgical efficiency, outcomes, and utilization.

Objectives/hypothesis: To test our hypothesis that high-surgeon volume is associated with improved surgical efficiency and 30-day outcomes, and lower hospital utilization.

Study Design: Retrospective observational cohort, 2008-2013.

Methods: A total of 3,135 patients with hemithyroidectomy or total thyroidectomy performed by a high-volume surgeon, propensity score-matched to 3,135 patients with the same procedure performed by a low-volume surgeon.

Evidence-Based Workflows for Thyroid and Parathyroid Surgery.

A need exists to reduce care variations by standardizing the practice of thyroid and parathyroid surgery. During the course of a year, a task force developed algorithms representing decision points and workflows based on American Thyroid Association guidelines and three internal studies of surgical practices in the Northern and Southern California Regions of Kaiser Permanente conducted in collaboration with Health Information Technology Transformation & Analytics (HITTA).

Risk of Complications after Thyroidectomy and Parathyroidectomy: A Case Series with Planned Chart Review.

Objective: To develop a predictive model for the risk of complications after thyroid and parathyroid surgery.

Study Design: Case series with planned chart review of patients undergoing surgery, 2007-2013.

Setting: Kaiser Permanente Northern California and Kaiser Permanente Southern California.

Sclerosing Polycystic Adenosis: A Rare Tumor of the Salivary Glands.

Case Presentation: A 74-year-old woman presented to the Head and Neck Surgery clinic with a 4-year history of a slowly growing, painful, left-sided neck mass in the tail of the parotid gland. Fine-needle aspiration suggested well-differentiated adenocarcinoma.

Discussion And Results: The patient underwent a superficial parotidectomy and super-selective neck dissection (level 2).

Safety of Outpatient Thyroid and Parathyroid Surgery: A Propensity Score-Matched Study.

Objective: To test our hypothesis that general and thyroid surgery-specific complications, mortality, and postdischarge utilization for patients undergoing outpatient and inpatient thyroid and parathyroid surgery would not differ when outpatient status was defined as discharge within 8 hours of surgery completion.

Study Design: Retrospective observational cohort, 2008 to 2013.

Setting: Kaiser Permanente Northern California and Kaiser Permanente Southern California.

Prospective, randomized, controlled trial of a hemostatic sealant in children undergoing adenotonsillectomy.

Objectives: To evaluate the efficacy of Floseal as a hemostatic sealant compared to traditional electrocautery hemostasis after cold knife adenotonsillectomy.

Study Design: Prospective, randomized, controlled trial of 68 consecutive patients undergoing cold steel adenotonsillectomy. Patients were randomized to receive either Floseal (FS) or electrocautery (EC) for hemostasis.

Voice, speech, and swallowing outcomes in laser-treated laryngeal cancer.

Objective: To describe preliminary voice, speech, and swallowing outcomes in patients treated by endoscopic laser excision of laryngeal cancer with or without adjuvant radiation therapy.

Study Design: Retrospective review.

Methods: Seventeen surgically treated patients (five T2 glottic and 12 clinically staged T2 supraglottic squamous cell carcinomas) participated in the study.

Intra-arterial effects of cisplatin on microvascular anastomoses in the rat model.

Objective: To evaluate the patency of microvascular anastomoses in arteries exposed to intra-arterial cisplatin.

Study Design: Animal model.

Methods: The common iliac artery of 15 rats was injected with 150 mg/m(2) cisplatin.