Walter Lee

Overview:

Global Health, Virtue-Based Professional Development and Leadership, Device Development for Cancer Detection

Positions:

Associate Professor of Surgery

Surgery, Head and Neck Surgery and Communication Sciences
School of Medicine

Associate Professor in Radiation Oncology

Radiation Oncology
School of Medicine

Affiliate, Duke Global Health Institute

Duke Global Health Institute
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1999

George Washington University

M.H.S. 2015

Duke University

Grants:

Enhanced ethanol ablation as a surgical-alternative for head and neck cancer treatment in resource-limited settings

Administered By
Biomedical Engineering
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Clinical Evaluation of the OncAlert® RAPID in Subjects Presenting for Evaluation and/or Initial Biopsy

Administered By
Surgery, Head and Neck Surgery and Communication Sciences
Role
Principal Investigator
Start Date
End Date

A Quantitative Optical Sensor to Monitor Tumor Vascular Physiology

Administered By
Radiation Oncology
Role
Investigator
Start Date
End Date

TERT promoter mutation frequency in subsets of oral tongue cancer patients

Administered By
Surgery, Head and Neck Surgery and Communication Sciences
Role
Principal Investigator
Start Date
End Date

CHECKPOINT Head & Neck Nerve Stimulator/Locator Product Validation Study (9394-CSP-000-B)

Administered By
Surgery, Head and Neck Surgery and Communication Sciences
Role
Principal Investigator
Start Date
End Date

Publications:

Establishing a Healthcare Research Network in Vietnam: A Platform for Collaborative Quality Improvement

© 2020, Springer Nature Singapore Pte Ltd. There is both a demand and need for delivering patient centered care in health systems. This is especially challenging in developing countries in which resources are limited, population health burdens are extensive, and coordination between facilities is fractured. The development of a low cost, centralized, real time data collection platform would be a powerful tool in understanding patient centered healthcare needs and issues. We report a pilot project that seeks to establish such a healthcare research network in Vietnam. This pilot used a web-based database collection tool called REDCap (Research Electronic Data Capture). We programmed a validated general health quality of life questionnaire in both English and Vietnamese that was used to collect patient responses. A total of four hospitals located in Hanoi, Vietnam participated in the pilot project of patients presenting with otolaryngology-head and neck complaints and concerns between January 23 and January 26, 2018. We report outpatient responses and their associated quality of life in ten specific domains. This pilot demonstrates the successful international collaboration among academic, non-profit, clinical entities in establishing this low-cost research network. This will be a platform that could easily be expanded to include other healthcare facilities in conducting quality improvement and research projects. We envision this approach as an important tool in improving health care quality in developing countries throughout the world.
Authors
Bui, AT; Trung, DD; Le Minh, K; Nguyen, T; Le Dinh, H; Tran, L; Nguyen, N; Vohra, P; Ji, KSY; Lee, E; Campbell, J; Lee, WT
MLA Citation
Bui, A. T., et al. “Establishing a Healthcare Research Network in Vietnam: A Platform for Collaborative Quality Improvement.” Ifmbe Proceedings, vol. 69, 2020, pp. 567–70. Scopus, doi:10.1007/978-981-13-5859-3_97.
URI
https://scholars.duke.edu/individual/pub1396460
Source
scopus
Published In
Ifmbe Proceedings
Volume
69
Published Date
Start Page
567
End Page
570
DOI
10.1007/978-981-13-5859-3_97

Distinct Angiogenic Changes during Carcinogenesis Defined by Novel Label-Free Dark-Field Imaging in a Hamster Cheek Pouch Model.

There remain gaps in knowledge concerning how vascular morphology evolves during carcinogenesis. In this study, we imaged neovascularization by label-free dark-field microscopy of a 7,12-Dimethylbenz[a]anthracene (DMBA)-induced hamster cheek pouch model of oral squamous cell carcinoma (SCC). Wavelength-dependent imaging revealed distinct vascular features at different imaging depths and vessel sizes. Vascular tortuosity increased significantly in high-risk lesions, whereas diameter decreased significantly in hyperplastic and SCC lesions. Large vessels preserved the same trends seen in the original images, whereas small vessels displayed different trends, with length and diameter increasing during carcinogenesis. On the basis of these data, we developed and validated a classification algorithm incorporating vascular features from different vessel masks. Receiver operator curves generated from the classification results demonstrated high accuracies in discriminating normal and hyperplasia from high-grade lesions (AUC > 0.94). Overall, these results provided automated imaging of vasculature in the earliest stages of carcinogenesis from which one can extract robust endpoints. The optical toolbox described here is simple, low-cost and portable, and can be used in a variety of health care and research settings for cancer prevention and pharmacology research. Cancer Res; 77(24); 7109-19. ©2017 AACR.
Authors
Hu, F; Martin, H; Martinez, A; Everitt, J; Erkanli, A; Lee, WT; Dewhirst, M; Ramanujam, N
MLA Citation
Hu, Fangyao, et al. “Distinct Angiogenic Changes during Carcinogenesis Defined by Novel Label-Free Dark-Field Imaging in a Hamster Cheek Pouch Model..” Cancer Res, vol. 77, no. 24, Dec. 2017, pp. 7109–19. Pubmed, doi:10.1158/0008-5472.CAN-17-1058.
URI
https://scholars.duke.edu/individual/pub1279483
PMID
29021136
Source
pubmed
Published In
Cancer Res
Volume
77
Published Date
Start Page
7109
End Page
7119
DOI
10.1158/0008-5472.CAN-17-1058

Epiglottic cyst causing dysphagia and impending airway obstruction.

Laryngeal cysts are relatively rare benign lesions of the larynx. Congenital cysts can cause neonatal respiratory distress and death, but airway obstruction due to acquired cysts in adults is rare. We present a case report of 51-year-old male with dysphagia who was found to have a mobile pedunculated epiglottic cyst that intermittently caused partial obstruction of the laryngeal inlet. Patient was taken to operating room and following transoral fiberoptic intubation, endoscopic excision of this cyst was accomplished. Patient's postoperative course was uneventful.
Authors
Collins, AM; Chapurin, N; Lee, WT
MLA Citation
Collins, Alissa M., et al. “Epiglottic cyst causing dysphagia and impending airway obstruction..” Am J Otolaryngol, vol. 36, no. 3, May 2015, pp. 492–93. Pubmed, doi:10.1016/j.amjoto.2015.02.002.
URI
https://scholars.duke.edu/individual/pub1058869
PMID
25683302
Source
pubmed
Published In
Am J Otolaryngol
Volume
36
Published Date
Start Page
492
End Page
493
DOI
10.1016/j.amjoto.2015.02.002

Physician allocation of Medicare resources for patients with advanced cancer.

BACKGROUND: Little is known about what patients and physicians value in end-of-life care, or how these groups would craft a health plan for those with advanced cancer. OBJECTIVE: The study objective was to assess how otolaryngology, head and neck surgery (OHNS) physicians would structure a Medicare benefit plan for patients with advanced cancer, and to compare this with cancer patient and cancer patient caregiver preferences. DESIGN: OHNS physicians used an online version of a validated tool for assessing preferences for health plans in the setting of limited resources. These data were compared to cancer patient and caregiver preferences. SETTING AND PARTICIPANTS: OHNS physicians nationwide were assessed with comparison to similar data obtained in a separate study of cancer patients and their caregivers treated at Duke University Medical Center. RESULTS: Otolaryngology physicians (n=767) completed the online assessment and this was compared with data from 146 patients and 114 caregivers. OHNS physician allocations differed significantly in 14 of the 15 benefit categories when compared with patients and caregivers. Physicians elected more coverage in the Advice, Emotional Care, Palliative Care, and Treatment for Cancer benefit categories. Patients and their caregivers elected more coverage in the Cash, Complementary Care, Cosmetic Care, Dental and Vision, Drug Coverage, Home Improvement, House Calls, Nursing Facility, Other Medical Care, and Primary Care benefit categories. CONCLUSIONS: Otolaryngology physicians have significantly different values in end-of-life care than cancer patients and their caregivers. This information is important for efficient allocation of scarce Medicare resources and for effective end-of-life discussions, both of which are key for developing appropriate health policy.
Authors
Rocke, DJ; Lee, WT; Beumer, HW; Taylor, DH; Schulz, K; Thomas, S; Puscas, L
MLA Citation
Rocke, Daniel J., et al. “Physician allocation of Medicare resources for patients with advanced cancer..” J Palliat Med, vol. 16, no. 8, Aug. 2013, pp. 857–66. Pubmed, doi:10.1089/jpm.2012.0636.
URI
https://scholars.duke.edu/individual/pub953280
PMID
23802131
Source
pubmed
Published In
Journal of Palliative Medicine
Volume
16
Published Date
Start Page
857
End Page
866
DOI
10.1089/jpm.2012.0636

Sentinel node biopsy for head and neck melanoma: a systematic review.

OBJECTIVE: This systematic review was conducted to examine the test performance of sentinel node biopsy in head and neck melanoma, including the identification rate and false-negative rate. DATA SOURCES: PubMed, EMBASE, ASCO, and SSO database searches were conducted to identify studies fulfilling the following inclusion criteria: sentinel node biopsy was performed, lesions were located on the head and neck, and recurrence data for both metastatic and nonmetastatic patients were reported. REVIEW METHODS: Dual-blind data extraction was conducted. Primary outcomes included identification rate and test performance based on completion neck dissection or nodal recurrence. RESULTS: A total of 3442 patients from 32 studies published between 1990 and 2009 were reviewed. Seventy-eight percent of studies were retrospective and 22% were prospective. Trials varied from 9 to 755 patients (median 55). Mean Breslow depth was 2.53 mm. Median sentinel node biopsy identification rate was 95.2%. More than 1 basin was reported in 33.1% of patients. A median of 2.56 sentinel nodes per patient were excised. Sentinel node biopsy was positive in 15% of patients. Subsequent completion neck dissection was performed in almost all of these patients and revealed additional positive nodes in 13.67%. Median follow-up was 31 months. Across all studies, predictive value positive for nodal recurrence was 13.1% and posttest probability negative was 5%. Median false-negative rate for nodal recurrence was 20.4%. CONCLUSION: Sentinel node biopsy of head and neck melanoma is associated with an increased false-negative rate compared with studies of non-head and neck lesions. Positive sentinel node status is highly predictive of recurrence.
Authors
de Rosa, N; Lyman, GH; Silbermins, D; Valsecchi, ME; Pruitt, SK; Tyler, DM; Lee, WT
MLA Citation
de Rosa, Nicole, et al. “Sentinel node biopsy for head and neck melanoma: a systematic review..” Otolaryngol Head Neck Surg, vol. 145, no. 3, Sept. 2011, pp. 375–82. Pubmed, doi:10.1177/0194599811408554.
URI
https://scholars.duke.edu/individual/pub733238
PMID
21540313
Source
pubmed
Published In
Otolaryngology Head and Neck Surgery : Official Journal of American Academy of Otolaryngology Head and Neck Surgery
Volume
145
Published Date
Start Page
375
End Page
382
DOI
10.1177/0194599811408554

Research Areas:

Academic Medical Centers
Adjuvants, Immunologic
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Alcohol Drinking
Algorithms
Ambulatory Care
Anastomosis, Surgical
Animals
Antigen Presentation
Antigens
Antigens, Neoplasm
Attitude of Health Personnel
Attitude to Health
Breast Neoplasms
Cancer Vaccines
Carcinoma, Squamous Cell
Career Choice
Caregivers
Cation Transport Proteins
Cell Differentiation
Cell Fusion
Cell Movement
Cell Separation
Cell Transplantation
Cells, Cultured
Chemotherapy, Adjuvant
Chi-Square Distribution
Child
Clinical Competence
Clinical Trials as Topic
Clinical trials
Cohort Studies
Combined Modality Therapy
Computer Simulation
Conflict of Interest
Constriction, Pathologic
Cranial Nerve Neoplasms
Critical Care
Cross-Sectional Studies
Curriculum
Cysts
Cytoskeletal Proteins
DNA Methylation
Data Interpretation, Statistical
Database
Debridement
Dendritic Cells
Diagnosis, Differential
Disease Models, Animal
Disease-Free Survival
Dose-Response Relationship, Drug
Drug Evaluation, Preclinical
Drug Therapy, Combination
Early Detection of Cancer
Edema
Education, Medical, Graduate
Electric Stimulation
Electrofusion
Electrophoresis
Emergency Treatment
Endoscopy
Enzyme-Linked Immunosorbent Assay
Esophageal Stenosis
Ethics
Evidence-Based Medicine
False Negative Reactions
Female
Fractures, Bone
GTP-Binding Proteins
Genes, Tumor Suppressor
Goiter
Head and Neck Neoplasms
Health Care Surveys
Health Priorities
Heart Defects, Congenital
Hemoglobins
Hernia
Herniorrhaphy
Hoarseness
Homeodomain Proteins
Hospitalization
Human papillomavirus 16
Humans
Hybrid Cells
Hypopharynx
Immunotherapy
Industry
Infant
Interferon-gamma
Interleukin-10
Interleukin-12
Internet
Internship and Residency
Intubation
Intubation, Intratracheal
Inventions
Laryngeal Diseases
Laryngeal Neoplasms
Laryngectomy
Laryngoplasty
Laryngoscopy
Laryngostenosis
Larynx
Laser Therapy
Leadership
Lung Neoplasms
Lymph Nodes
Lymphatic Metastasis
Lymphocyte Activation
Male
Mandibular Diseases
Melanoma
Melanoma, Experimental
Metals
Mice
Mice, Inbred BALB C
Mice, Inbred C57BL
Microsurgery
Microtubule-Associated Proteins
Middle Aged
Military Personnel
Monocytes
Monte Carlo Method
Moral Development
Mouth Neoplasms
Neck Dissection
Neoplasm Metastasis
Neoplasm Recurrence, Local
Neoplasm Staging
Neoplasm Transplantation
Neoplasms
Neoplastic Stem Cells
Nerve Tissue Proteins
Nerve Transfer
Nose
Nose Neoplasms
Organ Sparing Treatments
Organophosphorus Compounds
Osteoradionecrosis
Otolaryngology
Otorhinolaryngologic Diseases
Oxygen
Oxygen Consumption
Pain
Palliative Care
Papillomavirus Infections
Personnel Selection
Phantoms, Imaging
Physicians
Pilot Projects
Politics
Postoperative Care
Postoperative Complications
Prejudice
Preoperative Care
Professional Competence
Prognosis
Program Development
Program Evaluation
Promoter Regions, Genetic
Proto-Oncogene Proteins
Publication Bias
Questionnaires
Radiation Injuries
Radiometry
Radiotherapy
Radiotherapy, Adjuvant
Randomized Controlled Trials as Topic
Recombinant Fusion Proteins
Reconstructive Surgical Procedures
Recovery of Function
Reference Values
Registries
Resource Allocation
Respiratory Tract Neoplasms
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Sentinel Lymph Node Biopsy
Septins
Sex Factors
Signal Transduction
Skin Neoplasms
Smoking
Software
Specialties, Surgical
Specific Pathogen-Free Organisms
Spectrum Analysis
Statistics, Nonparametric
Surgical Procedures, Operative
Surveys and Questionnaires
Survival Analysis
Survival Rate
Suture Techniques
T-Lymphocytes
Tensile Strength
Terminally Ill
Thyroid Nodule
Time Factors
Toll-Like Receptors
Tongue
Tongue Diseases
Tongue Neoplasms
Tonsillar Neoplasms
Trachea
Tracheal Diseases
Tracheostomy
Tracheotomy
Transcription Factors
Treatment Outcome
Tumor Cells, Cultured
Tumor Markers, Biological
United States
Vaccines
Vaccines, Synthetic
Ventilators, Mechanical
Vestibulocochlear Nerve Diseases
Video Recording
Virtues
Vocal Cord Paralysis
Voice Disorders
Wounds, Nonpenetrating
Young Adult