About

Aaron M. Wieland is an Associate Professor in the Department of Otolaryngology-Head and Neck Surgery at the University of Wisconsin–Madison. He holds an MD from Harvard Medical School and completed his residency in Otolaryngology – Head & Neck Surgery at the Massachusetts Eye and Ear Infirmary in Boston. He further specialized through a fellowship in Head and Neck Surgical Oncology and Microvascular Reconstruction at the University of Wisconsin Hospital and Clinics. Certified by the American Board of Otolaryngology, Dr. Wieland's clinical expertise includes the treatment of head and neck cancer, voice and swallowing disorders, trauma, reconstruction, and robotic surgery. He serves as the chief of the otolaryngology service at the William S. Middleton Memorial Veterans Hospital and provides a wide range of surgical services such as airway reconstruction, laryngeal surgery, skull base surgery, and transoral robotic surgery, among others.

Research topics

• Medicine
• Surgery
• Internal medicine
• Oncology
• Cancer research

Selected publications

• Low Skeletal Muscle Mass as a Key Predictor of Postoperative Diet Outcomes in Circumferential Hypopharyngeal Cancer Reconstruction

  Laryngoscope Investigative Otolaryngology · 2026-04-01

  articleOpen access

  ABSTRACT Objective To evaluate the association between preoperative lumbar skeletal muscle index (LSMI) and postoperative dietary outcomes (regular diet versus texture‐modified diet) in patients undergoing circumferential hypopharyngeal cancer resection with tubed anterolateral thigh flap reconstruction. Methods This single‐center retrospective cohort study included 73 patients between 2009 and 2020. LSMI was calculated from lumbar skeletal muscle cross‐sectional area at the C3 vertebral level on preoperative CT scans. The primary outcome was dietary restriction, defined as Functional Oral Intake Scale ≤ 6 at ≥ 12 months postoperatively. Candidate predictors (pre‐, intra‐ and postoperative) with p < 0.20 in univariate screening underwent theory‐driven confounder assessment based on directed acyclic graphs, prior literature, and clinical knowledge. Change‐in‐estimate criterion (Δ β ≥ 10%) supported selecting confounding. LSMI components (C3CSA, L3CSA, age, sex, weight, height, BMI) were excluded from adjustment to prevent overadjustment for mediators and multicollinearity. The final model analyzed LSMI as a continuous predictor with logistic regression. Results Fifteen patients (20.5%) developed dietary restriction (FOIS < 7). Three confounders (Eichner A, Stage IV, hemoglobin) for LSMI were identified. Multivariable adjustment improved model fit (AIC: 65.8 → 63.4; Nagelkerke R 2 : 0.237 → 0.383) while maintaining statistical significance. Each 1 cm 2 /m 2 increase in LSMI was associated with a 16.1% reduction in the odds of FOIS < 7 (adjusted OR: 0.839; p = 0.006). The optimal LSMI cut‐off value was 42.82 cm 2 /m 2 . Conclusion Preoperative LSMI independently predicts long‐term dietary outcomes after hypopharyngeal reconstruction. Restricting the cohort to uniform resection and reconstruction methods clarified the relationship between skeletal muscle mass and swallowing function, enabling precise risk stratification and supporting targeted prehabilitation interventions. Level of Evidence 4.

  PublisherDOI

• Inconsistent Associations of Modified Frailty Index‐5 With Adverse Head and Neck Reconstruction Outcomes

  The Laryngoscope · 2025-01-27 · 5 citations

  articleOpen access

  OBJECTIVES: To investigate the consistency of associations between modified frailty index-5 (mFI-5) and postoperative adverse outcomes in head and neck cancer (HNC) reconstruction. METHODS: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2017 to 2022 was utilized to identify HNC patients undergoing locoregional or microvascular free tissue transfers. Kaplan-Meier estimates and multivariable Cox regression analyses were utilized to compare risk of infections, bleeding, readmissions, reoperations, major adverse cardiovascular events (MACE), and mortality within the first postoperative month for each mFI-5 score with mFI-5 = 0 as reference. Further analyses investigated associations between individual mFI-5 components and the outcomes of interest. RESULTS: We included 5,573 patients (median age: 64; 31.5% female), 63% (n = 3,519) of whom underwent microvascular free tissue transfers. Unadjusted univariate analyses associated higher mFI-5 scores with longer hospital stays. In locoregional tissue transfers, adjusted hazard ratios (aHRs) for reoperation were 1.37 (p = 0.03) for mFI-5 = 1 and 2.19 (p = 0.03) for mFI-5 ≥ 3. In microvascular free tissue transfers, aHRs for MACE were 1.93 (p = 0.04) for mFI-5 = 2 and 6.53 (p < 0.001) for mFI-5 ≥ 3, while aHRs for mortality was 3.88 (p = 0.04) for mFI-5 ≥ 3. No associations were observed between increasing mFI-5 scores and increased relative risk of infection, bleeding, or readmission. Individual component analysis associated congestive heart failure with aHRs of 3.92 (1.84-8.35; p < 0.001) for MACE and 5.30 (2.03-13.88; p < 0.001) for mortality. Additionally, COPD was associated with an aHR of 1.39 (1.16-1.67; p < 0.001) for infections. CONCLUSION: The associations of higher mFI-5 scores with postoperative adverse outcomes following oncoplastic head and neck reconstruction were inconsistent and possibly driven by individual effects of its components. LEVEL OF EVIDENCE: 3 Laryngoscope, 135:2342-2352, 2025.

  PublisherOA PDFDOI

• Survival outcomes of locoregionally advanced papillary thyroid carcinoma

  International Journal of Otorhinolaryngology and Head and Neck Surgery · 2025-07-25

  articleOpen access

  Background: PTC carries an overall excellent prognosis. Most patients with PTC have small and asymptomatic disease. This raises the question whether overall rates overestimate the survival of those with advanced disease. We use our institutional data to report disease-free and overall survival of patients with locoregionally advanced PTC. Methods: A retrospective study of 92 patients who underwent a total thyroidectomy from 2002 to 2019 at a single institution. Features of locoregionally advanced disease were defined as extra thyroid extension, primary tumor size ≥4 cm, or cervical nodal involvement. These and additional clinical and histological features were analyzed for association with recurrence and disease-free survival. Results: Twenty-six patients had recurrence of disease. Patients with ETE, nonspecific cervical nodal involvement, or tumor size ≥4 cm had no significant increase in recurrence (p=0.2554, 0.1886, 0.2278, respectively). Patients with nodal metastasis to lateral neck compartment had a significant increase in recurrence (p=0.0434). 5-year overall survival was 95%. Conclusion: PTC has an excellent prognosis even in the presence of advanced locoregional disease. However, lateral neck nodal involvement is associated with higher rates of recurrence and may be an indicator for more aggressive management.

  PublisherOA PDFDOI

• Tackling the implementation hurdle: User-centric validation of a machine-learning decision support tool for the screening of mild bleeding disorders

  Hämostaseologie · 2025-02-01

  article
  PublisherDOI

• Malignant Melanoma With Transdifferentiation Into a Ganglioneuroblastic Phenotype After Anti-PD-1 Therapy

  American Journal of Dermatopathology · 2025-07-28 · 1 citations

  article

  ABSTRACT: The clinicopathologic spectrum of dedifferentiated, undifferentiated, and transdifferentiated melanoma occurring de novo or following systemic therapy is gaining recognition. Here, we present a patient with locally advanced cutaneous melanoma who received neoadjuvant anti-PD-1 therapy and whose post-treatment excisional pathology revealed transdifferentiation into a ganglioneuroblastic phenotype. This rare phenotype is hypothesized to be connected to melanoma's shared origin from pluripotent neural crest cells. This case report highlights the proposed pathogenic mechanisms underlying this transition after immune checkpoint therapy, including the pathways and factors that affect the tumor and its microenvironment.

  PublisherDOI

• Safety and toxicity of Iopofosine I 131 (CLR 131) with external beam radiation therapy in recurrent or metastatic head and neck cancer: results of a phase 1 single-centre, open-label, single-arm, dose escalation and dose expansion study

  EBioMedicine · 2024-12-12 · 3 citations

  articleOpen access

  BACKGROUND: Re-irradiation of recurrent head and neck cancer (HNC) is often limited by tumour adherence to critical structures and/or radiation tolerance of critical normal tissues. Iopofosine I 131 (CLR 131) is a targeted small molecular phospholipid ether (PLE) drug conjugate that delivers iodine-131 selectively to tumour cells. We conducted a phase 1, single-centre, open-label study to determine whether CLR 131 given with reduced dose of external beam radiation therapy (EBRT) would be tolerable and feasible. METHODS: All participants received previous curative intent treatment with radiotherapy as primary or adjuvant treatment. Eligible participants demonstrated uptake of CLR 131 as indicated via single photon emission CT/CT (SPECT/CT) imaging following CLR 131 test dose. Participants received two therapeutic doses of CLR 131 (days 1 and 8) with SPECT/CT imaging performed to quantitate the biodistribution of CLR 131. Participants subsequently received EBRT to achieve the designated radiation dose (60-70 Gy). The primary endpoint was safety. This trial was registered with ClinicalTrials.gov, NCT04105543, and enrolment and follow-up are complete. FINDINGS: Twelve participants completed treatment with CLR 131 and EBRT. Eight participants experienced grade 4 non-DLT haematologic toxicities (2 anaemia, 8 leukopenia, 5 thrombocytopenia) at least probably attributed to CLR 131, consistent with the expected toxicity profile. Haematologic toxicities occurred during weeks 6-8 from the first dose of CLR 131 and resolved within three weeks without sequelae. There were no treatment-related grade 3-4 non-haematologic toxicities. INTERPRETATION: CLR 131 in combination with EBRT did not confer any safety concerns, and was tolerable in participants with recurrent/metastatic HNC. Myelosuppression was consistent with the known toxicity profile of CLR 131. FUNDING: National Institutes of HealthP50 DE026787, National Cancer InstituteP30 CA014520, National Institutes of Health1UL1TR002373, Cellectar, NCT04105543.

  PublisherDOI

• Imatinib plus Cetuximab as a Window of Opportunity Clinical Trial in Head and Neck Cancer

  International Journal of Radiation Oncology*Biology*Physics · 2024-03-14 · 1 citations

  article
  PublisherDOI

• Reconstruction After Skin Cancer Resection of the Head and Neck

  Otolaryngologic Clinics of North America · 2023-06-07 · 5 citations

  review
  PublisherDOI

• Data from Radiosensitization of Adenoid Cystic Carcinoma with MDM2 Inhibition

  2023-03-31

  preprintOpen access

  &lt;div&gt;Abstract&lt;p&gt;&lt;b&gt;Purpose:&lt;/b&gt; Adenoid cystic carcinoma (ACC) is a rare cancer arising from the major or minor salivary gland tissues of the head and neck. There are currently no approved systemic agents or known radiosensitizers for ACC. Unlike the more common head and neck squamous cell carcinomas that frequently harbor TP53 mutations, ACCs contain TP53 mutations at a rate of &lt;5%, rendering them an attractive target for MDM2 inhibition.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Experimental Design:&lt;/b&gt; We report the successful establishment and detailed characterization of a TP53-WT ACC patient-derived xenograft (PDX), which retained the histologic features of the original patient tumor. We evaluated this model for response to the MDM2 inhibitor AMG 232 as monotherapy and in combination with radiotherapy.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; AMG 232 monotherapy induced modest tumor growth inhibition, and radiation monotherapy induced a transient tumor growth delay in a dose-dependent fashion. Strikingly, combination treatment of AMG 232 with radiotherapy (including low-dose radiotherapy of 2 Gy/fraction) induced dramatic tumor response and high local tumor control rates 3 months following treatment. Posttreatment analysis revealed that although both AMG 232 and radiotherapy alone induced TP53 tumor-suppressive activities, combination therapy amplified this response with potent induction of apoptosis after combination treatment.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; These data identify that MDM2 inhibition can provide potent radiosensitization in TP53-WT ACC. In light of the absence of effective systemic agents for ACC, the powerful response profile observed here suggests that clinical trial evaluation of this drug/radiotherapy combination may be warranted to improve local control in this challenging malignancy. &lt;i&gt;Clin Cancer Res; 23(20); 6044–53. ©2017 AACR&lt;/i&gt;.&lt;/p&gt;&lt;/div&gt;

  PublisherDOI

• Interstitial Brachytherapy for Lip Cancer: Technical Aspects to Individualize Treatment Approach and Optimize Outcomes

  Practical Radiation Oncology · 2023-01-25 · 6 citations

  articleOpen access
  PublisherOA PDFDOI

Frequent coauthors

• Gregory K. Hartig

  44 shared

• Paul M. Harari

  University of Wisconsin Carbone Cancer Center

  42 shared

• Randall J. Kimple

  31 shared

• Matthew E. Witek

  22 shared

• Justine Y. Bruce

  University of Wisconsin–Madison

  20 shared

• Robert Lindau

  Methodist Hospital

  20 shared

• Aru Panwar

  Creighton University

  20 shared

• Daniel D. Lydiatt

  Pioneer (United States)

  17 shared

Labs

• Department of Human Oncology, UW School of Medicine and Public HealthPI