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Obstetrician & Gynecologist (OB/GYN), Oncology Specialist (cancer)
27 years of experience
Video profile
Accepting new patients

Credentials

Education ?

Medical School Score Rankings
Emory University (1984)
  •  
Top 25%

Awards & Distinctions ?

Awards  
Top 10 Doctor - City (2014)
Bedford, TX
Obstetrician & Gynecologist
Associations
Society of Gynecologic Oncology
American Board of Obstetrics and Gynecology

Affiliations ?

Dr. Messing is affiliated with 26 hospitals.

Hospital Affiliations

Score

Rankings

  • Harris Methodist H E B
    Medical Oncology
    1600 Hospital Pkwy, Bedford, TX 76022
    •  
    Top 25%
  • Texas Health Presbyterian Hospital Of Dallas
    Medical Oncology
    8200 Walnut Hill Ln, Dallas, TX 75231
    •  
    Top 25%
  • Texas Health Harris Methodist Hospital Southwest Fort Worth
    6100 Harris Pkwy, Fort Worth, TX 76132
    •  
    Top 25%
  • Texas Health Harris Methodist Hospital Fort Worth
    Medical Oncology
    1301 Pennsylvania Ave, Fort Worth, TX 76104
    •  
    Top 25%
  • Baylor Regional Medical Center At Grapevine
    Medical Oncology
    1650 W College St, Grapevine, TX 76051
    •  
    Top 25%
  • Medical Center Of Arlington
    3301 Matlock Rd, Arlington, TX 76015
    •  
    Top 50%
  • Texas Health Harris Methodist Hospital Azle
    108 Denver Trl, Azle, TX 76020
    •  
    Top 50%
  • Baylor Medical Center at Southwest Fort Worth
    Obstetrician & Gynecologist
    1400 8th Ave, Fort Worth, TX 76104
    •  
    Top 50%
  • Texas Health Arlington Memorial Hospital
    Medical Oncology
    800 W Randol Mill Rd, Arlington, TX 76012
    •  
    Top 50%
  • Baylor All Saints Medical Centers
    Medical Oncology
    1400 8th Ave, Fort Worth, TX 76104
    •  
  • Baylor Medical Center At Irving
    Medical Oncology
    1901 N MacArthur Blvd, Irving, TX 75061
    •  
  • Plaza Medical Center
    900 8th Ave, Fort Worth, TX 76104
    •  
  • North Hills Hospital
    Medical Oncology
    4401 Booth Calloway Rd, North Richland Hills, TX 76180
    •  
  • TX Health Arlington
  • Baylor All Saints Med Ctr -Fo, Fort Worth, Tx
  • Baylor Med Ctr -Grapevine, Grapevine, Tx
  • Harris Heb
  • Harris Continued Care Hospital
    1301 Pennsylvania Ave, Fort Worth, TX 76104
  • Harris Methodist - Springwood
    1608 Hospital Pkwy, Bedford, TX 76022
  • TX Health Southwest Fw
  • Baylor Grapevine
  • Texas Health Southwest Fort Worth
  • All Saints Hospital
  • TX Health Fort Worth
  • Texas Health HEB
  • Harris MethodistH E B North, Bedford, Tx
  • Publications & Research

    Dr. Messing has contributed to 13 publications.
    Title A Phase Ii, Open-label Study Evaluating Pazopanib in Patients with Recurrent Ovarian Cancer.
    Date September 2010
    Journal Gynecologic Oncology
    Excerpt

    The progression-free and median survival of patients with advanced ovarian cancer has not appreciably improved over the last decade. Novel targeted therapies, particularly antiangiogenic agents, may potentially improve clinical outcomes in patients with ovarian cancer. This phase II, open-label study evaluated oral pazopanib monotherapy in patients with low-volume recurrent ovarian cancer.

    Title Phase Ii Evaluation of Nanoparticle Albumin-bound Paclitaxel in Platinum-sensitive Patients with Recurrent Ovarian, Peritoneal, or Fallopian Tube Cancer.
    Date March 2009
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
    Excerpt

    Patients with recurrent ovarian, peritoneal, or fallopian tube cancer have limited therapeutic options. There are no reports of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in patients with recurrent platinum-sensitive disease. We report efficacy and toxicity with nab-paclitaxel in this group.

    Title Phase Ii Study of Sequential Doublets: Topotecan and Carboplatin, Followed by Paclitaxel and Carboplatin, in Patients with Newly Diagnosed Advanced Ovarian Cancer.
    Date September 2004
    Journal Gynecologic Oncology
    Excerpt

    OBJECTIVE: Incorporating topotecan into standard platinum/taxane chemotherapy for advanced ovarian cancer has been complicated by myelosuppression. This study evaluated sequential doublets of topotecan and carboplatin, followed by paclitaxel and carboplatin, in newly diagnosed advanced ovarian cancer patients. METHODS: Forty-five patients (median age, 56 years; range, 38-77 years) with stage III/IV disease and GOG performance status <2 were enrolled and received four cycles of topotecan (1.0 mg/m(2)/day on days 1 to 3) and carboplatin (AUC 4 on day 1), followed by four cycles of paclitaxel (175 mg/m(2) via 3-h IV infusion on day 1) and carboplatin (AUC 5 on day 1). All cycles were 21 days. Antitumor response was assessed after four and eight cycles; patients with clinical complete response (CR) underwent second-look laparotomy for determination of pathologic CR (PCR). Dose reductions were instituted for grade 4 neutropenia and thrombocytopenia, and for grade 3/4 nonhematologic toxicity. RESULTS: Among 41 CA-125 evaluable patients, complete and partial responses were observed in 29 (70.7%) and 11 (26.8%) patients, respectively. Of the 12 clinical CRs (43%) in 28 evaluable patients, 10 patients underwent second-look laparotomy, with 3 PCRs (30%). Median time to progression was 14 months and actuarial survival was 23 months. Neutropenia was the primary toxicity and cause of dose adjustments and delays, including two deaths. CONCLUSION: The antitumor activity observed is comparable with other series, although neutropenic complications were increased. Progression-free and actuarial survivals were slightly inferior. A Phase III trial (GOG 182) of sequential doublets in the reverse sequence is ongoing.

    Title Atypical Glandular Cells of Undetermined Significance and Adenocarcinoma in Situ: Summoning Colposcopic Expertise?
    Date September 1996
    Journal The Journal of Family Practice
    Excerpt

    In comparison with cervical squamous neoplasia, glandular cell neoplasia is uncommon. The evaluation of a patient with atypical glandular cells of undetermined significance is challenging because subtle colposcopic signs are frequently inaccessible to view and cytologic interpretations are extremely challenging for many cytopathologists.

    Title Mitotic Count, Nuclear Atypia, and Immunohistochemical Determination of Ki-67, C-myc, P21-ras, C-erbb2, and P53 Expression in Granulosa Cell Tumors of the Ovary: Mitotic Count and Ki-67 Are Indicators of Poor Prognosis.
    Date June 1996
    Journal Gynecologic Oncology
    Excerpt

    In spite of extensive research, the behavior of granulosa cell ovarian tumors remains unpredictable and is complicated by the lack of prognostic factors in early-stage disease. Forty patients with granulosa cell tumors were identified from tumor registries and data were analyzed for patient outcome. Mitotic count and nuclear atypia were determined at time of histological review. Paraffin-embedded archival tumor tissues from 32 of 40 patients were available, and immunohistochemical testing for Ki-67, c-myc, p21-ras, c-erbB2, and p53 was performed on archival tissues. Results were correlated with patients' outcome. Mitotic count and Ki-67 were found to be negatively associated with survival in granulosa cell tumors. Nuclear atypia, c-myc, p21-ras, c-erbB2, and p53 were not found to be of prognostic significance.

    Title Carcinoma of the Vulva in Young Women.
    Date July 1995
    Journal Obstetrics and Gynecology
    Excerpt

    OBJECTIVE: To determine if young women with carcinoma of the vulva have a different risk factor history and outcome compared with older women. METHODS: We conducted a retrospective review of the medical records of 78 women treated at the Medical College of Georgia for squamous carcinoma of the vulva during 1979-1993. Women younger than 45 years were compared with those 45 and over for historic risk factors, treatment modality, and outcome. RESULTS: Over the study interval, the average presenting age of these patients decreased from 69 to 55 years. Women under 45 were found to have a stronger history of condyloma (P < .001, 95% confidence interval [CI] 3.69-87.96). There was no significant difference by age in the duration of symptoms before presentation, smoking history, or tumor size. Women 45 and over were more likely to have advanced-stage disease (International Federation of Gynecology and Obstetrics [FIGO] stage III or IV) (P = .03, 95% CI 0.43-0.91). Treatment did not differ significantly with age. In a univariate analysis, advanced FIGO stage, presence of metastases, and tumor size were associated with shorter survival. There was no detected difference in survival for women in either age group. CONCLUSION: There appears to be a trend in our patient population toward younger women presenting with squamous carcinoma of the vulva. Human papillomavirus infection appears to be more common in younger women with vulvar carcinoma. There may be a difference in the etiologies producing squamous carcinomas of the vulva. Education encouraging the early detection and prevention of sexually transmitted diseases might alter the rising incidence of this disease in younger women.

    Title Vaginal Intraepithelial Neoplasia Iii Detected After Hysterectomy for Benign Conditions.
    Date January 1995
    Journal The Journal of Family Practice
    Excerpt

    Because primary vaginal cancer is rare, many experts discourage routine cytologic sampling of the vaginal vault following hysterectomy for benign circumstances. The following report describes a case of vaginal intraepithelial neoplasia III (VAIN III) detected by a vaginal vault Papanicolaou smear obtained from an asymptomatic 57-year-old woman 23 years after she had a total abdominal hysterectomy for a benign condition. As VAIN III is a true vaginal cancer precursor, the innocent disregard of recommended screening practices averted significant morbidity and possibility mortality for this otherwise healthy woman.

    Title Salvage Surgery for Chemorefractory Ovarian Germ Cell Tumors.
    Date December 1994
    Journal Gynecologic Oncology
    Excerpt

    This study was undertaken to determine whether secondary surgical debulking is beneficial for patients with malignant ovarian germ cell tumors (OGCT). Twenty patients with OGCT treated at our institution between 1975 and 1992 were retrospectively identified and analyzed. Survival was analyzed using the life-table methods of Kaplan and Meier and the statistical significance of various perioperative factors was tested by both the log-rank and the Wilcoxon tests. Histologic tumor type included 8 immature teratomas, 6 mixed tumors, 5 endodermal sinus tumors, and 1 dysgerminoma. After primary surgery, all patients received chemotherapy--non-platinum-based in 12 patients, platinum-based in 5, and both types in 3 patients. Treatment failure was classified as progression in 14 patients, persistence in 3, and recurrence in 3. Salvage surgery consisted of exploratory laparotomy and tumor debulking in 18 patients, inguinal lymphadenectomy in 1, and thoracotomy and wedge resection in 1. Sixteen patients subsequently received salvage chemotherapy. At the time of analysis, 11 patients were alive disease-free, 1 was alive with tumor, 6 had died of tumor progression, and 2 had died of treatment-related complications. Survival of patients with immature teratoma who underwent salvage surgery was significantly better than survival of those with other tumor cell types (P = 0.006). In conclusion, although the role of secondary debulking in chemorefractory OGCT remains undetermined, it may have some benefit for a select group of patients, particularly those with immature teratoma.

    Title Retroperitoneal Dissemination of Cervix Cancer Following Surgical Staging.
    Date June 1994
    Journal Gynecologic Oncology
    Excerpt

    Retroperitoneal and cutaneous dissemination of cervical carcinoma occurred following an extraperitoneal surgical staging procedure. This type of event may be rare or merely underreported in surgical staging literature. Extraperitoneal and laparoscopic staging procedures that result in piecemeal removal of tissue should be studied for the incidence of this type of recurrence.

    Title Large Loop Excision of the Transformation Zone (lletz): a Pathologic Evaluation.
    Date March 1994
    Journal Gynecologic Oncology
    Excerpt

    Forty-six LLETZ cone biopsies were performed at the Medical College of Georgia from January 1991 through December 1991. All LLETZ cones were performed for diagnostic reasons following colposcopic biopsies. The majority of procedures were done by residents in obstetrics and gynecology with direct faculty supervision. All specimens were critically evaluated by one pathologist with regard to specimen orientation, thermal artifact, margins, histologic diagnosis, and overall specimen adequacy. The median number of specimens obtained per patient was two, with a maximum of eight. Sixteen patients had a separate endocervical specimen obtained. Thermal artifact was graded as slight in 16 cases, moderate in 18 cases, and severe in 12 cases. The transformation zone was identified in 33 cases. Margins were positive in 17 cases, negative in 21 cases, and nonevaluable in 8 cases. Only 13 LLETZ specimens were believed to compare in quality to a cold-knife cone biopsy. The main criticism about the specimens was the effect of thermal artifact on critical histologic evaluation. In three cases, the thermal artifact precluded an accurate enough evaluation to rule out microinvasion. Mucosa missing at the margins or inadequate representation of the transformation zone were major reasons to call a specimen inadequate. Endocervical specimens suffered the most thermal injury. Orientation of fragmented cone specimens present a problem in histologic evaluation. A major emphasis needs to be placed on the proper indications for LLETZ cone biopsy as well as education of practitioners and pathologists in proper specimen handling.

    Title Paraaortic Lymph Node Sampling by Means of an Extraperitoneal Approach with a Supraumbilical Transverse "sunrise" Incision.
    Date September 1993
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    OBJECTIVES: Extraperitoneal approaches to removal of lymph nodes for staging in cervical cancer patients are numerous, and each has disadvantages. We developed a supraumbilical transverse incision to initiate irradiation within days of cervical cancer staging. STUDY DESIGN: Twenty patients with advanced stage IIB or IIIB cervical cancer underwent surgical staging with a supraumbilical incision during the time period Jan. 1, 1988, to Aug. 1, 1992. The incisions were made 6 cm above the umbilicus and carried laterally in a caudad manner to the iliac crests. All nodes were removed in an extraperitoneal fashion. RESULTS: In the 20 patients who were operated on, the mean number of nodes removed was 9.8. Estimated blood loss ranged from 50 to 300 ml. The procedure time ranged from 50 to 150 minutes. All patients but two had irradiation initiated within 2 weeks of the procedure. Complications included an identified and repaired ureteral injury, a prolonged ileus, and a small bowel obstruction. CONCLUSIONS: An extraperitoneal approach with the "sunrise" incision allows irradiation to begin within days of surgery. The operating time is relatively short. The incision can be extended caudally and extraperitoneally if needed for removal of bulky pelvic nodes.

    Title Metastatic Clear-cell Hidradenocarcinoma of the Vulva.
    Date March 1993
    Journal Gynecologic Oncology
    Excerpt

    Clear-cell hidradenocarcinoma is a malignant tumor of sweat gland origin. It is most often found on the trunk, head, and extremities. This case report describes a rare occurrence of this tumor on the vulva of a young woman. The discovery of metastatic disease reflects the potentially aggressive nature of this tumor.

    Title Primary Treatment Failure in Patients with Malignant Ovarian Germ Cell Neoplasms.
    Date
    Journal International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society
    Excerpt

    Between 1970 and 1990, 160 patients with malignant non-dysgerminomatous ovarian germ cell tumors have been treated at our own institution. Primary therapy failed in 42 of these patients, who constitute the basis for this study. Seventeen patients had stage I disease, 5 stage II, 17 stage III, and 3 stage IV. Histologic type included 13 immature teratomas, 8 endodermal sinus tumors, and 21 mixed germ cell tumors. Primary therapy for 14 patients was surgery alone, for 23, surgery plus chemotherapy, for 2, surgery plus radiotherapy and for 3, all three modalities. Median progression-free survival from initial diagnosis lasted 6.8 months (range, 0.9-24 months). Thirty-four patients received chemotherapy as part of salvage; 5/11 (45%) who received VAC are disease-free, and 6/11 (55%) who received cisplatin combinations are disease-free. When primary VAC failed, 3/7 (43%) were salvaged with cisplatin combinations. When primary cisplatin combinations failed, 2/5 (40%) were salvaged. Twelve of the 42 patients (29%) are currently alive disease-free. Primary treatment failure was attributed to surgery alone for 14 patients (7 because of misdiagnosis), radiotherapy for 5, and toxicity for 1. Of the 22 patients who failed chemotherapy, 12 did so because of a suboptimal regimen, 3 because of possible dose-intensity problems, one because of non-compliance, and 6 for unexplained reasons. Patients with ovarian germ cell tumors have an excellent probability of cure with aggressive primary therapy, but successful salvage may be difficult when primary treatment fails.

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