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Nicole Fleming, M.D.

Present Title & Affiliation

Primary Appointment

Assistant Professor, Gynecologic Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
Center Medical Director, MD Anderson Sugar Land Cancer Center, Sugar Land, TX

Bio Statement

 Dr. Fleming is an Assistant Professor in the Department of Gynecologic Oncology at M.D. Anderson Cancer Center. Dr. Fleming returns to the Houston area after completing her residency training in Obstetrics and Gynecology at Duke University Medical Center and fellowship in Gynecologic Oncology at University of California at Los Angeles Medical Center.

 As a member of the M. D. Anderson Outreach Program, Dr. Fleming provides medical and surgical care to women with gynecologic malignancies in the greater Houston area.  She has privileges at St. Luke’s Episcopal Hospital, the Woman’s Hospital of Texas, Methodist Hospital, and Lyndon B. Johnson Hospital which enable patients to be seen in a private-practice office setting with access to the amenities and specialized services of M. D. Anderson Cancer Center including clinical trials. Dr. Fleming believes in working closely with the patient and the referring doctor in order to provide quality care through a comprehensive, multidisciplinary approach.

Dr. Fleming has a special interest in minimally invasive surgery, including robotic-assisted laparoscopy, for appropriate patients with cervical, endometrial, and early-stage ovarian cancers.  Minimally invasive surgery has revolutionized care for patients with gynecologic malignancies while improving patients’ quality of life postoperatively. In addition to providing excellent patient care, Dr. Fleming continues to pursue her research interests which include surgical innovation and outcomes in gynecologic malignancies, and personalizing treatment options for patients with ovarian and endometrial cancer. She has authored and co-authored numerous articles in peer-reviewed journals on these and other subjects.  In addition, she has been invited to write book chapters on a variety of topics in gynecologic oncology. 

Dr. Fleming is a member of the American College of Obstetricians and Gynecologists, the American Society of Clinical Oncology, Society of Gynecologic Oncologists, and American Association of Gynecologic Laparoscopists. In addition, she serves as reviewer for several journals including Gynecologic Oncology and Annals of Surgical Oncology.

Education & Training

Degree-Granting Education

2004 University of Texas Medical School, Houston, TX, MD, Medicine
2000 Texas A&M University, College Station, TX, BS, Summa Cum Laude, Biomedical Science

Postgraduate Training

7/2008-6/2011 Clinical Fellowship, Gynecologic Oncology, University of California, Los Angeles, CA
7/2004-6/2008 Clinical Residency, Obstetrics and Gynecology, Duke University Medical Center, Durham, NC

Board Certifications

11/2012 American Board of Obstetrics and Gynecology

Experience/Service

Institutional Committee Activities

Member, Department of Gynecologic Oncology, Surgery Working Group, 9/2011-present
Member, Department of Gynecologic Oncology, Endometrial Working Group, 9/2011-present
Member, Department of Gynecologic Oncology, Developmental Therapeutics Working Group, 9/2011-present
Member, Department of Gynecologic Oncology, Fellowship Planning Committee, 9/2011-present

Honors and Awards

2012 GCF Carol's Cause Award for Outstanding Paper by Fellow/Resident
2010-2011 UCLA K30 Graduate Training Program in Translational Investigation, University of California Los Angeles
2010 AACR Molecular Biology in Clinical Oncology Workshop, Aspen, CO
2007-2008 Administrative Chief Resident, Duke University Medical Center
2007-2008 Outstanding Surgeon Award, Duke University Medical Center
2007 Felix Rutledge Fellowship, M. D. Anderson Cancer Center
2006-2007 Medical Student Teaching Award, Duke University Medical Center
2003-2004 Developmental Anatomy Award, University of Texas Medical School
2003-2004 Neuroscience Award, University of Texas Medical School
2001-2003 Massenburg Scholarship, University of Texas Medical School
2001-2002 George Longshie Scholarship, University of Texas Medical School
2001-2002 Joe T. Nelson Scholarship Award, University of Texas Medical School
1999-2000 Outstanding Biomedical Science Student Award, Texas A&M University
1996-2000 Dean's Honor List, Texas A&M University
1995-1996 Scholarship - AT&T Academic Award, Texas A&M University
1995-1996 Scholarship - Meadow's Foundation, Texas A&M University
1995-1996 Scholarship - Texas A&M Opportunity Award, Texas A&M University

Professional Memberships

American Association of Gynecologic Laparoscopy
Member, 10/2011-present
American College of Obstetrics and Gynecology
Junior Fellow in Practice, 1/2004-present
American Society of Clinical Oncology
Member, 1/2010-present
Society of Gynecologic Oncologists
Member, 1/2009-present

Selected Publications

Peer-Reviewed Original Research Articles

1. Neubauer NL, Havrilesky LJ, Calingaert B, Bulusu A, Bernardini MQ, Fleming ND, Bland AE, Secord AA. The role of lymphadenectomy in the management of preoperative grade 1 endometrial carcinoma. Gynecol Oncol 112(3):511-6, 3/2009. e-Pub 1/13/2009. PMID: 19144394.
2. Secord AA, Havrilesky LJ, O'Malley DM, Bae-Jump V, Fleming ND, Broadwater G, Cohn DE, Gehrig PA. A multicenter evaluation of sequential multimodality therapy and clinical outcome for the treatment of advanced endometrial cancer. Gynecol Oncol 114(3):442-7, 9/2009. e-Pub 6/26/2009. PMID: 19560193.
3. Fleming ND, Alvarez-Secord A, Von Gruenigen V, Miller MJ, Abernethy AP. Indwelling catheters for the management of refractory malignant ascites: a systematic literature overview and retrospective chart review. J Pain Symptom Manage 38(3):341-9, 9/2009. e-Pub 3/28/2009. PMID: 19328648.
4. Fleming ND, Havrilesky LJ, Valea FA, Allen TK, Broadwater G, Bland A, Habib AS. Analgesic and antiemetic needs following minimally invasive vs open staging for endometrial cancer. Am J Obstet Gynecol 204(1):65.e1-6, 1/2011. PMID: 20869036.
5. Fleming ND, Lentz SE, Cass I, Li AJ, Karlan BY, Walsh CS. Is older age a poor prognostic factor in stage I and II endometrioid endometrial adenocarcinoma? Gynecol Oncol 120(2):189-92, 2/2011. e-Pub 11/26/2010. PMID: 21112078.
6. Barnett JC, Havrilesky LJ, Bondurant AE, Fleming ND, Lee PS, Secord AA, Berchuck A, Valea FA. Adverse events associated with laparoscopy vs laparotomy in the treatment of endometrial cancer. Am J Obstet Gynecol 205(2):143.e1-6, 8/2011. e-Pub 3/16/2011. PMID: 21514921.
7. Fleming ND, Cass I, Walsh CS, Karlan BY, Li AJ. CA125 surveillance increases optimal resectability at secondary cytoreductive surgery for recurrent epithelial ovarian cancer. Gynecol Oncol 121(2):249-52, 5/2011. e-Pub 5/2011. PMID: 21300398.
8. Fleming ND, Ramirez PT. Robotic surgery in gynecologic oncology. Curr Opin Oncol 24(5):547-53, 9/2012. PMID: 22581356.
9. Fleming ND, Agadjanian H, Nassanian H, Miller CW, Orsulic S, Karlan BY, Walsh CS. XPC single nucleotide polymorphisms correlate with prolonged progression-free survival in advanced ovarian cancer. Cancer 118(118):689-97, 2/1/2012. e-Pub 7/12/2011. PMID: 21751198.
10. Slaughter KN, Frumovitz M, Schmeler KM, Nick AM, Fleming ND, dos Reis R, Munsell MF, Westin SN, Soliman PT, Ramirez PT. Minimally invasive surgery for endometrial cancer: does operative start time impact surgical and oncologic outcomes? Gynecol Oncol 134(2):248-52, 8/2014. e-Pub 6/16/2014. PMCID: PMC4286393.
11. Penner KR, Fleming ND, Barlavi L, Axtell AE, Lentz SE. Same-day discharge is feasible and safe in patients undergoing minimally invasive staging for gynecologic malignancies. Am J Obstet Gynecol 212(2):186.e1-8, 2/2015. e-Pub 8/14/2014. PMID: 25132462.
12. Jones N, Fleming ND, Nick AM, Munsell MF, Rallapalli V, Westin SN, Meyer LA, Schmeler KM, Ramirez PT, Soliman PT. Conversion from robotic surgery to laparotomy: A case-control study evaluating risk factors for conversion. Gynecol Oncol 134(2):238-242, 8/2014. e-Pub 6/14/2014. PMCID: PMC4125462.
13. Fleming ND, Frumovitz M, Schmeler KM, dos Reis R, Munsell MF, Eifel PJ, Soliman PT, Nick AM, Westin SN, Ramirez PT. Significance of lymph node ratio in defining risk category in node-positive early stage cervical cancer. Gynecol Oncol 136(1):48-53, 1/2015. e-Pub 11/18/2014. PMID: 25451695.
14. Ulm MA, Fleming ND, Rallapali V, Munsell MF, Ramirez PT, Westin SN, Nick AM, Schmeler KM, Soliman PT. Position-related injury is uncommon in robotic gynecologic surgery. Gynecol Oncol 135(3):534-8, 12/2014. e-Pub 10/23/2014. PMCID: PMC4268144.
15. Carroll A, Ramirez PT, Westin SN, Soliman PT, Munsell MF, Nick AM, Schmeler KM, Klopp AH, Fleming ND. Uterine adenosarcoma: An analysis on management, outcomes, and risk factors for recurrence. Gynecol Oncol 135(3):455-61, 12/2014. e-Pub 10/28/2014. PMID: 25449308.
16. Clark LH, Soliman PT, Munsell M, Odetto D, Schmeler KM, Fleming N, Westin SN, Nick AM, Ramirez PT. Incidence of trocar site herniation following robotic gynecologic surgery. Gynecol Oncol 131(2):400-3, 2013.
17. Fleming ND, Ramirez PT. Robotic surgery in gynecologic oncology. Curr Opin Oncol 24(5):547-53, 2012.
18. Gomez-Hidalgo NR, Darin MC, Dalton H, Jhingran A, Fleming N, Brown J, Ramirez PT. Ovarian torsion after laparoscopic ovarian transposition in patients with gynecologic cancer: a report of 2 cases. J Minim Invasive Gynecol. e-Pub 2015.
19. Turner TB, Habib AS, Broadwater G, Valea FA, Fleming ND, Ehrisman JA, Di Santo N, Havrilesky LJ. Postoperative pain scores and narcotic use in robotic-assisted versus laparoscopic hysterectomy for endometrial cancer staging. J Minim Invasive Gynecol pii: S1553-4650(15):00402-1, Sep-Oct, 9/2015. e-Pub 5/9/2015. PMID: 25967934.
20. Fleming ND, Soliman PT, Westin SN, Reis RD, Munsell M, Klopp AH, Frumovitz M, Nick AM, Schmeler K, Ramirez PT. Impact of lymph node ratio and adjuvant therapy in node-positive endometrioid endometrial cancer. Int J Gynecol Cancer 25(8):1437-44, 10/2015. PMCID: PMC4581897.
21. Arms RG, Sun CC, Burzawa JK, Fleming ND, Nick AM, Rallapalli V, Westin SN, Meyer LA, Ramirez PT, Soliman PT. Improvement in quality of life after robotic surgery results in patient satisfaction. Gynecol Oncol 138(3):727-30, 9/2015. e-Pub 7/18/2015. PMID: 26197762.

Editorials

1. Fleming ND. Extraperitoneal Lymphadenectomy in Gynecologic Malignancies. AAGL NewsScope 26(7), 2012.

Abstracts

1. Fleming ND, Coleman RL, Tung C, Munsell MF, Sood AK. Phase II trial of Bevacizumab with Carboplatin and Dose-dense Paclitaxel as First-Line Treatment in Patients with Advanced Ovarian Cancer. SGO 46th Annual Meeting on Women’s Cancer, 3/2015.
2. Holman L, Soliman PT, Broaddus R, Fleming ND, Dockery L, Klopp A, Lu KH, Munsell M, Navdeep P, Shiozaki T, Westin SN. Platinum-free interval is a predictor of survival for recurrent, advanced stage uterine papillary serous carcinoma. SGO 46th Annual Meeting on Women’s Cancer, 3/2015.
3. Soliman PT, Westin SN, Fleming ND, Ramirez PT, Nick AM, Sun C, Levenback C, Frumovitz M, Dioun S, Lu KH. Sentinel lymph node mapping accurately identifies positive nodes in women with high risk endometrial cancer. SGO 46th Annual Meeting on Women’s Cancer, 3/2015.
4. Nick AM, Ramirez PT, Schmeler KM, Westin SN, Fleming ND. Outcomes of pelvic exenteration: Does surgeon experience matter?. SGO 45th Annual Meeting on Women's Cancer, 2014.
5. Holman LL, Iglesias PT, Soliman NP, Klopp A, Broaddus R, Ayeni T, Fleming ND, Munsell MF, Lu KH, Westin SN. Long-term survival in advanced-stage uterine papillary serous carcinoma. American Society of Clinical Oncology Annual Meeting, 6/2013.
6. Holman L, Soliman P, Pal N, Balakrishnan N, Klopp A, Broaddus R, Fleming N, Munsell M, Lu K, Westin S. , March 2013. Importance of platinum sensitivity and treatment modality in advanced-stage uterine papillary serous carcinoma. SGO 44th Annual Meeting on Women’s Cancer, 3/2013.
7. Soliman, P, Sun C, Westin S, Fleming N, Schmeler K, Nick A, Ramirez PT. Improvement in quality of life after robotic surgery results in patient satisfaction. SGO 44th Annual Meeting on Women's Cancer, 3/2013.
8. Carroll A, Ramirez PT, Westin S, Soliman P, Munsell M, Nick A, Schmeler K, Frumovtiz M, Klopp A, Fleming N. Uterine adenosarecoma: A closer look at a rare disease. SGO 44th Annual Meeting, 3/2013.
9. Frumovitz M; Hall TR; Sun CC; Fleming N; Ty ED; Ramirez PT. The utility of routine cyctoscopy after total laparoscopic hysterectomy. 41st AAGL Global Congress of Minimally Invasive Gynecology, 11/2012.
10. Fleming ND, Penner K, Barlavi L, Axtell AE, Lentz SE. Is overnight hospitalization a necessity in minimally invasive gynecologic oncology surgery. SGO 43rd Annual Meeting on Women’s Cancer, 3/2012.
11. Bandyopdhyay J, Munsell M, Schmeler KM,Nick AM, Westin SN, Frumovitz M, Fleming N, Ramirez PT, Soliman PT. Risk Factors Associated with Conversion to Laparotomy in Patients Undergoing Robotic Surgery. 41st AAGL Global Congress of Minimally Invasive Gynecology, 2012.
12. Fleming ND, Axtell A, Lentz SE. Operative and anesthesia outcomes in endometrial cancer staging via 3 minimally invasive methods. Western Association of Gynecologic Oncologists Annual Meeting, 6/2011.
13. Fleming ND, Agadjanian H, Nassanian H, Miller CW, Orsulic S, Karlan BY, Walsh CS. XPC single nucleotide polymorphisms correlate with prolonged progression-free survival in advanced ovarian cancer. SGO 42nd Annual Meeting on Women’s Cancer, 3/2011.
14. Fleming ND, Cass I, Walsh CS, Karlan BY, Li AJ. Early detection of recurrence through CA125 surveillance in women with epithelial ovarian cancer correlates with increased optimal secondary cytoreductive surgery. SGO 41st Annual Meeting on Women’s Cancer, March 2010. Western Association of Gynecologic Oncologists Annual Meeting, 6/2010.
15. Fleming ND, Lentz SE, Cass I, Li AJ, Karlan BY, Walsh CS. Is older age a poor prognostic factor in stage I and II endometrioid endometrial cancer?. Western Association of Gynecologic Oncologists Annual Meeting, 6/2009.
16. Fleming ND, Havrilesky LJ, Valea FA, Allen TK, Broadwater G, Bland A, Habib AS. Minimally invasive staging for endometrial cancer is associated with lower pain, nausea, and narcotic use. SGO 40th Annual Meeting on Women’s Cancer, 2/2009.
17. Havrilesky AJ, Fleming N, Darcy K, Miner Z, Hutson A, Berchuck A, Secord AA. Correlations between cell cycle regulatory genes and relationship to ovarian cancer prognosis: a Gynecologic Oncology Group study. SGO 38th Annual Meeting on Women’s Cancer, 3/2007.

Book Chapters

1. Fleming ND, Coleman RL, Sood AK. Clinical Decision Support Project. In: Targeted Therapies in Ovarian Cancer. In Press.
2. Fleming ND, Farias-Eisner R. Malignant Diseases of the Ovary and Fallopian Tube. In: DiSaia: Women’s Health Review: A Clinical Update in Obstetrics-Gynecology. Elsevier. In Press.
3. Fleming ND, Dorigo O, Goodman A. Premalignant and Malignant Disorders of the Uterine Corpus. In: Current Diagnosis and Treatment: Obstetrics and Gynecology 11th edition. McGraw-Hill. In Press.
4. Fleming ND. Fertility Preservation in the Gynecologic Cancer Patient. In: Gynecologic Oncology: Evidence-Based Perioperative and Supportive Care, 2nd edition. Wiley-Blackwell: Hoboken, NJ, 2011.

Last updated: 11/18/2015