Melonie Nance - Academia.edu (original) (raw)

Papers by Melonie Nance

Clinical Cancer Research, Jan 3, 2023

Laryngoscope, 2009

Objective:Early detection of head and neck cancer is associated with improved survival. It is unc... more Objective:Early detection of head and neck cancer is associated with improved survival. It is unclear if screening programs successfully target high‐risk populations. We sought to determine the characteristics of participants presenting for a free oral, head and neck cancer screening.Materials and Methods:Prospective analysis of 89 participants in a one‐day, free oral, head, and neck cancer screening.Results:The majority of participants were female (57%) and not tobacco users (71%) with a mean age of 56 years (range, 23–83). Symptoms associated with head and neck cancer were reported by 59 participants (66%), but only 31 (35%) were aware of an association between symptoms and head and neck cancer. There was no correlation between symptom prevalence and exam findings (r = 0.1161). Ten participants (11%) had findings concerning for neoplasia and were referred for immediate consultation. Demographically, 64 (72%) of participants had attended college and 51 (57%) earned an annual income greater then $30,000. The majority of participants (85%) believed that screening increased their awareness and knowledge of oral and head and neck cancer.Conclusions:Free oral, head and neck cancer screenings increase awareness of oral and head and neck cancer and identify a subset of individuals requiring further evaluation. However, participants do not share characteristics of the population at greatest risk for the development of head and neck cancer based on risk factors and socioeconomic status. These findings suggest that early detection efforts need to be designed to target high‐risk populations. Laryngoscope, 2009

Cancer Research, Apr 14, 2023

Cancer Research

Purpose: Neoadjuvant targeted therapy provides a brief, preoperative ‘window of opportunity’ that... more Purpose: Neoadjuvant targeted therapy provides a brief, preoperative ‘window of opportunity’ that can be exploited to individualize cancer care based on treatment response. We investigated whether response to neoadjuvant therapy during the preoperative window confers survival benefit in patients with operable head and neck squamous cell carcinoma (HNSCC). Patients and Methods: A pooled analysis of treatment naïve patients with operable HNSCC enrolled in one of three clinical trials from 2009-2020 (NCT00779389, NCT01218048, NCT02473731). Neoadjuvant regimens consisted of EGFR inhibitors (n=83) or anti-ErbB3 antibody therapy (n=9) within 28 days of surgery. Clinical to pathologic stage migration was compared to disease-free survival (DFS) and overall survival (OS) while adjusting for confounding factors using multivariable Cox regression. Circulating tumor markers validated in other solid tumor models were analyzed. Results: 92 of 118 patients were analyzed; all patients underwent sur...

Patient characteristics of control group

CONSORT diagram of patients included neoadjuvant targeted therapy trials

Detection of methylated DNA in plasma of HNSCC patients

Purpose:Neoadjuvant targeted therapy provides a brief, preoperative window of opportunity that ca... more Purpose:Neoadjuvant targeted therapy provides a brief, preoperative window of opportunity that can be exploited to individualize cancer care based on treatment response. We investigated whether response to neoadjuvant therapy during the preoperative window confers survival benefit in patients with operable head and neck squamous cell carcinoma (HNSCC).Patients and Methods:A pooled analysis of treatment-naïve patients with operable HNSCC enrolled in one of three clinical trials from 2009 to 2020 (NCT00779389, NCT01218048, NCT02473731). Neoadjuvant regimens consisted of EGFR inhibitors (n = 83) or anti-ErbB3 antibody therapy (n = 9) within 28 days of surgery. Clinical to pathologic stage migration was compared with disease-free survival (DFS) and overall survival (OS) while adjusting for confounding factors using multivariable Cox regression. Circulating tumor markers validated in other solid tumor models were analyzed.Results:92 of 118 patients were analyzed; all patients underwent s...

Representativeness of study participants

Comparison of clinical to pathologic stage migration between patients enrolled in 1 of 4 window t... more Comparison of clinical to pathologic stage migration between patients enrolled in 1 of 4 window trials compared to a second control group

Clinical Cancer Research

Circulation, 2021

In the United States, race-based disparities in cardiovascular disease care have proven to be per... more In the United States, race-based disparities in cardiovascular disease care have proven to be pervasive, deadly, and expensive. African American/Black, Hispanic/Latinx, and Native/Indigenous American individuals are at an increased risk of cardiovascular disease and are less likely to receive high-quality, evidence-based medical care as compared with their White American counterparts. Although the United States population is diverse, the cardiovascular workforce that provides its much-needed care lacks diversity. The available data show that care provided by physicians from racially diverse backgrounds is associated with better quality, both for minoritized patients and for majority patients. Not only is cardiovascular workforce diversity associated with improvements in health care quality, but racial diversity among academic teams and research scientists is linked with research quality. We outline documented barriers to achieving workforce diversity and suggest evidence-based strat...

Journal of the American College of Cardiology, 2021

The United States is home to individuals from a variety of races whose social identities reflect ... more The United States is home to individuals from a variety of races whose social identities reflect different ethnicities, cultures, nationalities, and life experi

The Annals of otology, rhinology, and laryngology, Jan 17, 2015

The aim of this study is to describe the feasibility as well as oncologic outcomes of robot-assis... more The aim of this study is to describe the feasibility as well as oncologic outcomes of robot-assisted neck dissection (RAND) through a modified facelift incision in an American population. Retrospective case series. University tertiary care hospital. All patients who underwent RAND between November 2012 and December 2014 were included. Medical records were reviewed for demographics, medical histories, staging, operative information, postoperative hospital course and complications, and oncologic outcomes. There were 11 RANDs identified among 10 patients. Five patients had known nodal metastasis at the time of surgery. Two patients had been previously irradiated. The average time of surgery was 284.4 ± 72.3 minutes, including other associated procedures. The average lymph node yield was 28.5 ± 9.3 nodes. There were no major complications. Average follow-up was 19.4 months. There was 1 supraclavicular recurrence in a previously irradiated patient. All patients are currently alive and wi...

Epidemiology, Pathogenesis, and Prevention of Head and Neck Cancer, 2010

Squamous cell carcinoma of the upper aerodigestive tract (head and neck squamous cell carcinoma, ... more Squamous cell carcinoma of the upper aerodigestive tract (head and neck squamous cell carcinoma, HNSCC) is often considered to be a single disease based on the cell of origin (mucosal epithelium) and histologic features. However, distinctive phenotypic patterns and genotypic correlates increasingly suggest that it might be more accurately thought of as consisting of different entities. These observations have been

The Laryngoscope, 2012

Objectives/Hypothesis:In 2% to 3% of patients with cancer metastatic to cervical lymph nodes, a p... more Objectives/Hypothesis:In 2% to 3% of patients with cancer metastatic to cervical lymph nodes, a primary tumor will not be found despite exhaustive diagnostic efforts. The treatment for these patients includes cervical lymphadenectomy followed by radiation to areas with increased risk of harboring a mucosal primary. Wide‐field radiation therapy increases the incidence of xerostomia and dysphagia. Localizing a primary tumor has thus both therapeutic and quality‐of‐life implications, allowing possible complete surgical excision, concentrated radiation therapy, and potential deintensification of adjuvant therapy. With improved visualization and freedom of motion, transoral robotic surgery (TORS) is an innovative surgical modality that allows resection of oropharyngeal subsites with minimal morbidity.Study Design:Retrospective chart review.Methods:Ten patients with unknown primary tumors of the head and neck were identified. All patients underwent a cervical biopsy, positron‐emission tom...

The Laryngoscope, 2009

Cancer, 2008

BACKGROUND-Histopathologic grade of mucoepidermoid carcinoma (MEC) is an established predictor of... more BACKGROUND-Histopathologic grade of mucoepidermoid carcinoma (MEC) is an established predictor of prognosis and affects treatment protocol. Tumor behavior is more aggressive in high-grade than in low-grade MEC, leading to a more intensive treatment protocol. Outcomes for patients with intermediate-grade MEC are less clear; therefore, the optimal treatment protocol for this group is not well defined. The treatment protocol and survival outcomes of patients treated for MEC of the head and neck was investigated. METHODS-A retrospective clinical review and prospective review of histopathologic grading were undertaken using the most recently established grading system of 50 patients with MEC of the head and neck from 1983 through 2004. RESULTS-As histologic grade increased from low to intermediate to high, overall survival (P <.0001) and disease-free survival (P <.001) were significantly decreased. Overall and disease-free survival were significantly better for patients with intermediate-grade MEC than those with highgrade disease. Overall and disease-free survival were similar for patients with low-grade and intermediate-grade MEC. There was a low rate of disease recurrence in patients with intermediategrade MEC, but this did not lead to death from disease. Although no patients with low-grade or intermediate-grade MEC died of disease, 52% of patients with high-grade MEC died of disease. Multivariate analysis revealed that histologic grade, age, and surgical margin status significantly predicted prognosis. CONCLUSIONS-These findings suggest that, under the current histopathologic classification system, the behavior of intermediate-grade MEC is comparable to that of low-grade MEC and