About

Karthik Rajasekaran, MD, FACS, is an Associate Professor of Otorhinolaryngology: Head and Neck Surgery at the Hospital of the University of Pennsylvania. He serves as the Director of Facial Trauma and the Director of Quality Improvement Education at the University of Pennsylvania. Dr. Rajasekaran is also a Senior Fellow of the Leonard Davis Institute of Health Economics at the University of Pennsylvania and is the Co-Director of the Head and Neck Oncology and Microvascular Reconstruction Fellowship at the same institution. His professional roles include being a Head/Neck Oncology Leadership Meeting Member of the Cancer Service Line at the Hospital of the University of Pennsylvania. His academic and clinical focus is on head and neck oncology, facial trauma, and microvascular reconstruction. Dr. Rajasekaran's work involves advancing patient care, surgical education, and health economics within his specialty.

Research topics

• Medicine
• Surgery
• Internal medicine
• Family medicine
• Nursing
• Physical therapy
• Medical education
• Medical emergency
• Oncology
• Pedagogy
• Psychology

Selected publications

• Publisher Correction: Tissue-resident exhausted and memory CD8+ T cells have distinct ontogeny, function and roles in disease

  Nature Immunology · 2026-01-13

  articleOpen access
  PublisherOA PDFDOI

• Mohs-Facilitated Excision: A Case Series of a Multidisciplinary Approach to Reduce Local Recurrence of Advanced Keratinocyte Carcinomas

  Journal of the American Academy of Dermatology · 2026-04-01

  article
  PublisherDOI

• Long-Term Results of a Phase 2 Clinical Trial of Radiation Volume and Dose Deintensification Following Transoral Robotic Surgery and Neck Dissection for Human Papillomavirus–Associated Oropharyngeal Squamous Cell Carcinoma

  International Journal of Radiation Oncology*Biology*Physics · 2026-04-01

  article
  PublisherDOI

• Accuracy of Sentinel Lymph Node Biopsy to Predict Nodal Metastasis in Head and Neck Merkel Cell Carcinoma

  JAMA Otolaryngology–Head & Neck Surgery · 2026-01-29

  articleOpen access

  Importance: Merkel cell carcinoma (MCC) is a rare neuroendocrine malignant neoplasm often affecting the head and neck. Sentinel lymph node biopsy (SLNB) is routinely performed; however, the accuracy and reliability of SLNB for head and neck MCC remains unknown. Objective: To determine the accuracy of SLNB in head and neck MCC and inform pre- and post-SLNB risk stratification. Design, Setting, and Participants: This was a single-center cohort study of patients with clinically node-negative head and neck MCC who underwent SLNB from January 2006 to January 2025; median (IQR) follow-up was 1.9 (0.8-4.6) years. Data analysis was conducted from April to November 2025. Interventions: SLNB outcome and nodal disease status. Main Outcomes and Measures: SLNB accuracy measured by sensitivity, negative predictive value (NPV), and false negative (FN) rate. FN SLNB was defined as regional nodal recurrence at the first site of recurrence after a negative SLNB without concurrent local or in-transit recurrence. Factors associated with failed SLNB (defined as nonvisualization on lymphoscintigraphy, inability to identify the sentinel lymph node intraoperatively, or absence of nodal tissue in the pathology specimen) were evaluated using effect-size measures. Cox proportional hazards model identified factors associated with nodal disease, comparing patients who developed nodal disease (identified by SLNB or subsequent clinical and/or imaging evaluation) with those who did not develop nodal disease during follow-up. Results: Of 86 participants (mean [SD] age, 75.6 [9.6] years; 36 female [41.9%] and 50 male [58.1%] individuals) with clinically node-negative head and neck MCC, 69 (80.2%) underwent SLNB. Occult nodal disease was identified in 19 participants (27.5%). SLNB sensitivity was 52.6% (10 of 19 patients), NPV was 88.6% (31 of 35 patients), and FN rate was 26.7% (4 of 15 patients). SLNB failed in 29.0% (20 of 69 patients), with tumor location, female sex, and older age having medium to large effect on SLNB failure. Lymphovascular invasion, infiltrative growth pattern, and tumor size had the largest effect size on nodal disease with Cox analysis. Conclusions and Relevance: In this large single-site cohort study, SLNB remained a useful tool in head and neck MCC, identifying more than half of occult nodal disease. Given reduced performance in this region, patients with failed SLNB or negative SLNB plus high-risk features may benefit from tailored management, including intensified therapy and surveillance.

  PublisherOA PDFDOI

• Supplementary Table S4 from <i>In Situ</i> Proinflammatory Effects of Dazostinag Alone or with Chemotherapy on the Tumor Microenvironment of Patients with Head and Neck Squamous Cell Carcinoma

  2025-07-30

  supplementary-materialsOpen access

  <p>Table S4. Number of regions of interest (ROIs) analyzed for each patient and drug condition in the boxplots shown in Figures 3, 4, and 5.</p>

  PublisherDOI

• Differences in Survival Following Surgery Versus Chemoradiotherapy for Clinical Stage T4a Laryngeal Squamous Cell Carcinoma: A Propensity Score‐Matched Analysis

  Head & Neck · 2025-12-16

  articleOpen access

  BACKGROUND: Although laryngeal cancer incidence has declined in the United States, case fatality has risen. The survival equivalence of surgery versus chemoradiotherapy (CRT) for cT4a laryngeal squamous cell carcinoma (LSCC) remains uncertain. METHODS: We conducted a retrospective cohort study of cT4a LSCC patients treated with curative-intent surgery or CRT using the National Cancer Database (2010-2021). Those receiving neoadjuvant or palliative therapy, or with distant metastases were excluded. Survival was assessed using Kaplan-Meier and Cox models after 1:1 propensity score matching. RESULTS: Among 3569 patients (mean age 61.0, 708 female), 2437 (68.3%) underwent surgery while 1132 (31.7%) received CRT. In the matched cohort (n = 452 per arm), median survival was 52.8 (95% CI: 45.6-62.4) versus 37.6 (95% CI: 29.2-45.4) months for surgery versus CRT. Adjusted HR for CRT relative to surgery was 1.26 (95% CI: 1.02-1.57). CONCLUSIONS: Surgery was associated with improved overall survival compared with definitive CRT in patients with T4a LSCC.

  PublisherOA PDFDOI

• Figure 5 from <i>In Situ</i> Proinflammatory Effects of Dazostinag Alone or with Chemotherapy on the Tumor Microenvironment of Patients with Head and Neck Squamous Cell Carcinoma

  2025-07-30

  preprintOpen access

  <p>Dazostinag + CPPT + PTX induced tumor cell apoptosis at 24 hours postintratumoral injection. Staining with the apoptosis marker CC3 showed minimal change at sites with dazostinag alone, a modest increase when treated with carboplatin + paclitaxel, and significantly elevated CC3 at sites with dazostinag + carboplatin + paclitaxel. Cell nuclei, blue; CC3, red; CIVO GLO, green. The number of regions of interest analyzed for each patient and drug conditions is detailed in Supplementary Table S4. CC3, cleaved caspase-3; CPPT, carboplatin; PTX, paclitaxel.</p>

  PublisherDOI

• Outcomes of <scp>HPV</scp> + Oropharyngeal Carcinoma of Unknown Primary Following Transoral Robotic Surgery

  The Laryngoscope · 2025-08-13 · 2 citations

  articleOpen accessSenior authorCorresponding

  OBJECTIVES: Treatment of patients with head and neck squamous cell carcinoma of unknown primary (CUP) is challenging. Given the relative rarity of this condition and the recent use of primary transoral robotic surgery (TORS) in modern diagnostic and treatment algorithms, long-term oncologic outcomes are unclear. The objectives were to evaluate oncologic outcomes of patients treated with TORS for management of CUP. METHODS: This retrospective case series was conducted at a tertiary care academic medical center from 2010 to 2021. All patients with HPV-mediated CUP who underwent TORS-assisted endoscopy were included. CUP was defined as biopsy-proven squamous cell carcinoma in a cervical lymph node with uncertain primary location following standard-of-care clinical and radiologic assessment. Primary outcomes were recurrence-free survival and overall survival. Secondary outcomes included usage of radiation and chemotherapy. RESULTS: In total, 157 patients were included in the study. Median follow-up time was 62 months. Primary tumor was identified in 88% of patients. Surgery alone was performed in 21%, although adjuvant therapy was recommended but declined in 13%. Adjuvant radiation was completed in 46% and adjuvant chemoradiation in 33%. Two-thirds of patients avoided chemoradiation. Overall survival was 94% and recurrence-free survival was 92% at 5 years. CONCLUSION: In the largest reported experience to date of TORS-assisted management of CUP, we demonstrate that this approach facilitates a high rate of identification of occult mucosal malignancies and can eliminate the need for chemotherapy and potentially radiation therapy in select patients without compromising excellent oncologic and functional outcomes.

  PublisherOA PDFDOI

• Feasibility and preliminary efficacy of a lymphedema and fibrosis self-management program for head and neck cancer survivors: a pilot randomized controlled trial

  Oral Oncology · 2025-08-06 · 6 citations

  articleOpen access

  OBJECTIVES: Survivors of head and neck cancer (HNC) are at high risk for developing lymphedema and fibrosis (LEF). Once diagnosed with LEF, survivors must engage in a lifelong program of self-care to minimize long-term adverse effects. However, evidence-based LEF self-management (SM) programs are lacking. To fill this void, we developed and pilot-tested a LEF-SM program for HNC survivors. MATERIALS AND METHODS: The LEF-SM Program was developed using the Information-Motivation-Behavioral Skills model of health behavior change as a framework. The program was pilot tested in a three-group randomized controlled trial evaluating feasibility and preliminary efficacy. Fifty-nine participants were randomized to: Usual care (n = 20), usual care plus LEF-SM Program (n = 20), and usual care plus LEF-SM Program plus lymphedema therapist follow-up (n = 19). Assessments were conducted at baseline, 3-, 6-, 9-, and 12-month. Outcomes included feasibility and preliminary efficacy (LEF progression, symptom burden, and jaw range of motion). Multivariate covariance pattern model analysis was used to test differences between groups. RESULTS: 1) Feasibility: 97.4% of the participants completed three of three planned LEF self-management skill training sessions, 92.1% completed at least two of three planned motivational interviewing sessions, and 82.3% completed at least two of three planned lymphedema therapist follow-up sessions. Participant satisfaction with the LEF-SM Program was high. No adverse events were reported. 2) Preliminary Efficacy: Compared to usual care, LEF-SM Program (± follow-up) showed a decrease in LEF severity and symptom burden (p < 0.05). CONCLUSION: The LEF-SM Program is feasible and potentially efficacious. Further testing is warranted for this novel program addressing an unmet need for HNC survivors. TRIAL REGISTRATION: This study was registered on January 22, 2017, at ClinicalTrials.gov, a service of the US National Institute of Health (NCT03030859). The URL of the trial registry record:https://www. CLINICALTRIALS: gov/study/NCT03030859.

  PublisherDOI

• Supplementary Table S3 from &lt;i&gt;In Situ&lt;/i&gt; Proinflammatory Effects of Dazostinag Alone or with Chemotherapy on the Tumor Microenvironment of Patients with Head and Neck Squamous Cell Carcinoma

  2025-07-30

  supplementary-materialsOpen access

  &lt;p&gt;Table S3. Representativeness of the study population.&lt;/p&gt;

  PublisherDOI

Frequent coauthors

• Jason G. Newman

  Medical University of South Carolina

  68 shared

• Alvaro Moreira

  The University of Texas Health Science Center at San Antonio

  53 shared

• Steven B. Cannady

  University of Pennsylvania

  47 shared

• Robert M. Brody

  University of Pennsylvania

  46 shared

• Kevin Chorath

  University of Pennsylvania

  45 shared

• Ryan M. Carey

  Philadelphia VA Medical Center

  35 shared

• Aman Prasad

  University of Pennsylvania

  32 shared

• Emma De Ravin

  Thomas Jefferson University

  31 shared

Labs

• Karthik Rajasekaran LabPI

Awards & honors

• Senior Fellow of the Leonard Davis Institute of Health Econo…