Photo of Andrew L. Warshaw,  MD

Andrew L. Warshaw, MD

Massachusetts General Hospital

Massachusetts General Hospital
Phone: (617) 726-8254
Fax: (617) 726-7593

Andrew L. Warshaw, MD

Massachusetts General Hospital


  • W. Gerald Austen Distinguished Professor of Surgery, Surgery, Harvard Medical School
  • Surgeon-in-Chief and Chairman, Surgery, Massachusetts General Hospital


Research Abstract

My laboratory has developed a model of pancreatic cancer in the rat by implantation of the carcinogen DMBA in the pancreas. We are characterizing the genetic mutations which accumulate in the carcinogenesis sequence, attempting to develop from this tumor a cell line and tranplantable cancer in nude mice or inbred strains. We are using the model and other cells lines to study the mechanisms of action of chemotherapeutic agents. We are also trying to replicate the model in mice to allow the use of knockout technology as a tool for dissecting pathogenetic factors.

We have a pancreatic cancer database which we use to study outcomes of treatment, and have a particular focus on staging by laparoscopy, peritoneal cytology, and a newly developed technique for detecting circulating pancreatic cancer cells in the bloodstream.

We are characterizing the genetic mutations (K-ras, P-53, etc.) and molecular factors (i.e. telomerase expression) in a library of pancreatic cystic neoplasms and intraductal papillary-mucinous tumors along the spectrum of their malignancy.


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  • Morales-Oyarvide V, Mino-Kenudson M, Ferrone CR, Gonzalez-Gonzalez LA, Warshaw AL, Lillemoe KD, Fernández-Del Castillo C. Acute pancreatitis in intraductal papillary mucinous neoplasms: A common predictor of malignant intestinal subtype. Surgery 2015. PubMed
  • Yamaguchi J, Liss AS, Sontheimer A, Mino-Kenudson M, Castillo CF, Warshaw AL, Thayer SP. Pancreatic duct glands (PDGs) are a progenitor compartment responsible for pancreatic ductal epithelial repair. 2015; 15:190-202. PubMed
  • Sahora K, Ferrone CR, Brugge WR, Morales-Oyarvide V, Warshaw AL, Lillemoe KD, Fernández-Del Castillo C. Effects of Comorbidities on Outcomes of Patients With Intraductal Papillary Mucinous Neoplasms. Clin Gastroenterol Hepatol 2015. PubMed
  • Kulemann B, Pitman MB, Liss AS, Valsangkar N, Fernández-Del Castillo C, Lillemoe KD, Hoeppner J, Mino-Kenudson M, Warshaw AL, Thayer SP. Circulating Tumor Cells Found in Patients With Localized and Advanced Pancreatic Cancer. Pancreas 2015. PubMed
  • Marchegiani G, Mino-Kenudson M, Ferrone CR, Morales-Oyarvide V, Warshaw AL, Lillemoe KD, Castillo CF. Patterns of Recurrence After Resection of IPMN: Who, When, and How? Ann Surg 2015. PubMed
  • Marchegiani G, Mino-Kenudson M, Ferrone CR, Warshaw AL, Lillemoe KD, Fernández-Del Castillo C. Oncocytic-Type Intraductal Papillary Mucinous Neoplasms: A Unique Malignant Pancreatic Tumor with Good Long-Term Prognosis. J Am Coll Surg 2015. PubMed
  • Valsangkar NP, Ingkakul T, Correa-Gallego C, Mino-Kenudson M, Masia R, Lillemoe KD, Fernández-del Castillo C, Warshaw AL, Liss AS, Thayer SP. Survival in ampullary cancer: potential role of different KRAS mutations. Surgery 2015; 157:260-8. PubMed
  • Fong ZV, Correa-Gallego C, Ferrone CR, Veillette GR, Warshaw AL, Lillemoe KD, Fernández-Del Castillo C. Early Drain Removal-The Middle Ground Between the Drain Versus No Drain Debate in Patients Undergoing Pancreaticoduodenectomy: A Prospective Validation Study. Ann Surg 2015. PubMed
  • Ferrone CR, Marchegiani G, Hong TS, Ryan DP, Deshpande V, McDonnell EI, Sabbatino F, Santos DD, Allen JN, Blaszkowsky LS, Clark JW, Faris JE, Goyal L, Kwak EL, Murphy JE, Ting DT, Wo JY, Zhu AX, Warshaw AL, Lillemoe KD, Fernández-del Castillo C. Radiological and surgical implications of neoadjuvant treatment with FOLFIRINOX for locally advanced and borderline resectable pancreatic cancer. Ann Surg 2015; 261:12-7. PubMed
  • Lee GC, Fong ZV, Ferrone CR, Thayer SP, Warshaw AL, Lillemoe KD, Fernández-Del Castillo C. High performing whipple patients: factors associated with short length of stay after open pancreaticoduodenectomy. J Gastrointest Surg 2014; 18:1760-9. PubMed
  • Fong ZV, Peev M, Warshaw AL, Lillemoe KD, Castillo CF, Velmahos GC, Fagenholz PJ. Single-Stage Cholecystectomy at the Time of Pancreatic Necrosectomy Is Safe and Prevents Future Biliary Complications: a 20-Year Single Institutional Experience with 217 Consecutive Patients. J Gastrointest Surg 2014. PubMed
  • Sahora K, Fernández-del Castillo C, Dong F, Marchegiani G, Thayer SP, Ferrone CR, Sahani DV, Brugge WR, Warshaw AL, Lillemoe KD, Mino-Kenudson M. Not all mixed-type intraductal papillary mucinous neoplasms behave like main-duct lesions: implications of minimal involvement of the main pancreatic duct. Surgery 2014; 156:611-21. PubMed
  • Konstantinidis IT, Kambadakone A, Catalano OA, Sahani DV, Deshpande V, Forcione DG, Wargo JA, Fernandez-Del Castillo C, Lillemoe KD, Warshaw AL, Ferrone CR. Lymphoepithelial cysts and cystic lymphangiomas: Under-recognized benign cystic lesions of the pancreas. World J Gastrointest Surg 2014; 6:136-41. PubMed
  • Sahora K, Morales-Oyarvide V, Thayer SP, Ferrone CR, Warshaw AL, Lillemoe KD, Fernández-Del Castillo C. The effect of antecolic versus retrocolic reconstruction on delayed gastric emptying after classic non-pylorus-preserving pancreaticoduodenectomy. Am J Surg 2014. PubMed
  • Marchegiani G, Mino-Kenudson M, Sahora K, Morales-Oyarvide V, Thayer S, Ferrone C, Warshaw AL, Lillemoe KD, Fernández-Del Castillo C. IPMN Involving the Main Pancreatic Duct: Biology, Epidemiology, and Long-Term Outcomes Following Resection. Ann Surg 2014. PubMed
  • Fong ZV, Ferrone CR, Thayer SP, Wargo JA, Sahora K, Seefeld KJ, Warshaw AL, Lillemoe KD, Hutter MM, Fernández-Del Castillo C. Understanding hospital readmissions after pancreaticoduodenectomy: can we prevent them?: a 10-year contemporary experience with 1,173 patients at the Massachusetts General Hospital. J Gastrointest Surg 2014; 18:137-44; discussion 144-5. PubMed
  • Cai S, Hong TS, Goldberg SI, Fernandez-del Castillo C, Thayer SP, Ferrone CR, Ryan DP, Blaszkowsky LS, Kwak EL, Willett CG, Lillemoe KD, Warshaw AL, Wo JY. Updated long-term outcomes and prognostic factors for patients with unresectable locally advanced pancreatic cancer treated with intraoperative radiotherapy at the Massachusetts General Hospital, 1978 to 2010. Cancer 2013; 119:4196-204. PubMed
  • Sahora K, Mino-Kenudson M, Brugge W, Thayer SP, Ferrone CR, Sahani D, Pitman MB, Warshaw AL, Lillemoe KD, Fernandez-del Castillo CF. Branch duct intraductal papillary mucinous neoplasms: does cyst size change the tip of the scale? A critical analysis of the revised international consensus guidelines in a large single-institutional series. Ann Surg 2013; 258:466-75. PubMed
  • Valsangkar NP, Bush DM, Michaelson JS, Ferrone CR, Wargo JA, Lillemoe KD, Fernández-del Castillo C, Warshaw AL, Thayer SP. N0/N1, PNL, or LNR? The effect of lymph node number on accurate survival prediction in pancreatic ductal adenocarcinoma. J Gastrointest Surg 2013; 17:257-66. PubMed
  • Yamasaki A, Booker A, Kapur V, Tilt A, Niess H, Lillemoe KD, Warshaw AL, Conrad C. The impact of music on metabolism. Nutrition 2012; 28:1075-80. PubMed
  • Konstantinidis IT, Warshaw AL, Allen JN, Blaszkowsky LS, Fernandez-Del Castillo C, Deshpande V, Hong TS, Kwak EL, Lauwers GY, Ryan DP, Wargo JA, Lillemoe KD, Ferrone CR. Pancreatic Ductal Adenocarcinoma: Is There a Survival Difference for R1 Resections Versus Locally Advanced Unresectable Tumors? What Is a "True" R0 Resection? Ann Surg 2012. PubMed
  • Warshaw AL, Lillemoe KD, Fernandez-del Castillo C. Pancreatic surgery for adenocarcinoma. Curr Opin Gastroenterol 2012; 28:488-93. PubMed
  • Fernández-del Castillo C, Morales-Oyarvide V, McGrath D, Wargo JA, Ferrone CR, Thayer SP, Lillemoe KD, Warshaw AL. Evolution of the Whipple procedure at the Massachusetts General Hospital. Surgery 2012; 152:S56-63. PubMed
  • Ferrone CR, Pieretti-Vanmarcke R, Bloom JP, Zheng H, Szymonifka J, Wargo JA, Thayer SP, Lauwers GY, Deshpande V, Mino-Kenudson M, Fernández-del Castillo C, Lillemoe KD, Warshaw AL. Pancreatic ductal adenocarcinoma: long-term survival does not equal cure. Surgery 2012; 152:S43-9. PubMed
  • Cogdill AP, Frederick DT, Cooper ZA, Garber HR, Ferrone CR, Fiedler A, Rosenberg L, Thayer SP, Warshaw AL, Wargo JA. Targeting the MAGE A3 antigen in pancreatic cancer. Surgery 2012; 152:S13-8. PubMed
  • Valsangkar NP, Morales-Oyarvide V, Thayer SP, Ferrone CR, Wargo JA, Warshaw AL, Fernández-del Castillo C. 851 resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital. Surgery 2012; 152:S4-12. PubMed
  • Zaydfudim V, Sarr MG, Harken AH, Warshaw AL. Tumor vs neoplasm: It is not just semantics. Surgery 2012. PubMed
  • Bausch D, Pausch T, Krauss T, Hopt UT, Fernandez-Del-Castillo C, Warshaw AL, Thayer SP, Keck T. Neutrophil granulocyte derived MMP-9 is a VEGF independent functional component of the angiogenic switch in pancreatic ductal adenocarcinoma. Angiogenesis 2011. PubMed
  • Ferrone CR, Konstantinidis IT, Sahani DV, Wargo JA, Fernandez-Del Castillo C, Warshaw AL. Twenty-Three Years of the Warshaw Operation for Distal Pancreatectomy with Preservation of the Spleen. Ann Surg 2011. PubMed
  • Kalva SP, Yeddula K, Wicky S, Fernandez Del Castillo C, Warshaw AL. Angiographic Intervention in Patients With a Suspected Visceral Artery Pseudoaneurysm Complicating Pancreatitis and Pancreatic Surgery. Arch Surg 2011. PubMed
  • Masia R, Mino-Kenudson M, Warshaw AL, Pitman MB, Misdraji J. Pancreatic mucinous cystic neoplasm of the main pancreatic duct. Arch Pathol Lab Med 2011; 135:264-7. PubMed
  • Bausch D, Thomas S, Mino-Kenudson M, Fernández-del CC, Bauer TW, Williams M, Warshaw AL, Thayer SP, Kelly KA. Plectin-1 as a novel biomarker for pancreatic cancer. Clin Cancer Res 2011; 17:302-9. PubMed
  • Konstantinidis IT, Dursun A, Zheng H, Wargo JA, Thayer SP, Fernandez-del Castillo C, Warshaw AL, Ferrone CR. Metastatic tumors in the pancreas in the modern era. J Am Coll Surg 2010; 211:749-53. PubMed
  • Warshaw AL. Distal pancreatectomy with preservation of the spleen. 2010; 17:808-12. PubMed
  • Warshaw AL. Four decades fighting pancreatic cancer. Am Surg 2010; 76:921-4. PubMed
  • LaFemina J, Vagefi PA, Warshaw AL, Fernández-del Castillo C. Transgastric pancreaticogastric anastomosis: an alternative operative approach for middle pancreatectomy. Arch Surg 2010; 145:476-81. PubMed
  • Fritz S, Fernández-Del Castillo C, Iafrate AJ, Mino-Kenudson M, Neyhard N, Lafemina J, Stirman A, Warshaw AL, Thayer SP. Novel Xenograft and Cell Line Derived From an Invasive Intraductal Papillary Mucinous Neoplasm of the Pancreas Give New Insights Into Molecular Mechanisms. Pancreas 2010; 39:308-14. PubMed
  • Strobel O, Rosow DE, Rakhlin EY, Lauwers GY, Trainor AG, Alsina J, Fernández-Del Castillo C, Warshaw AL, Thayer SP. Pancreatic duct glands are distinct ductal compartments that react to chronic injury and mediate Shh-induced metaplasia. Gastroenterology 2010; 138:1166-77. PubMed
  • Partelli S, Fernandez-Del Castillo C, Bassi C, Mantovani W, Thayer SP, Crippa S, Ferrone CR, Falconi M, Pederzoli P, Warshaw AL, Salvia R. Invasive intraductal papillary mucinous carcinomas of the pancreas: predictors of survival and the role of lymph node ratio. Ann Surg 2010; 251:477-82. PubMed
  • Crippa S, Fernández-Del Castillo C, Salvia R, Finkelstein D, Bassi C, Domínguez I, Muzikansky A, Thayer SP, Falconi M, Mino-Kenudson M, Capelli P, Lauwers GY, Partelli S, Pederzoli P, Warshaw AL. Mucin-producing neoplasms of the pancreas: an analysis of distinguishing clinical and epidemiologic characteristics. Clin Gastroenterol Hepatol 2010; 8:213-9. PubMed
  • Konstantinidis IT, Deshpande V, Zheng H, Wargo JA, Fernandez-del Castillo C, Thayer SP, Androutsopoulos V, Lauwers GY, Warshaw AL, Ferrone CR. Does the mechanism of lymph node invasion affect survival in patients with pancreatic ductal adenocarcinoma? J Gastrointest Surg 2010; 14:261-7. PubMed
  • Correa-Gallego C, Ferrone CR, Thayer SP, Wargo JA, Warshaw AL, Fernández-Del Castillo C. Incidental pancreatic cysts: do we really know what we are watching? Pancreatology 2010; 10:144-50. PubMed
  • ElBardissi AW, Regenbogen SE, Greenberg CC, Berry W, Arriaga A, Moorman D, Retik A, Warshaw AL, Zinner MJ, Gawande AA. Communication practices on 4 Harvard surgical services: a surgical safety collaborative. Ann Surg 2009; 250:861-5. PubMed
  • Warshaw AL. 2009 American Pancreatic Association presidential address: on our 40th birthday. Pancreas 2009; 38:844. PubMed
  • Bausch D, Mino-Kenudson M, Fernández-Del Castillo C, Warshaw AL, Kelly KA, Thayer SP. Plectin-1 is a biomarker of malignant pancreatic intraductal papillary mucinous neoplasms. J Gastrointest Surg 2010; 13:1948-54; discussion 1954. PubMed
  • Hill JS, McPhee JT, Whalen GF, Sullivan ME, Warshaw AL, Tseng JF. In-hospital mortality after pancreatic resection for chronic pancreatitis: population-based estimates from the nationwide inpatient sample. J Am Coll Surg 2009; 209:468-76. PubMed
  • Warshaw AL. Health care reform: we all have a dog in this hunt. Bull Am Coll Surg 2009; 94:18-9. PubMed
  • Nelson AL, Millington TM, Sahani D, Chung RT, Bauer C, Hertl M, Warshaw AL, Conrad C. Hepatic portal venous gas: the ABCs of management. Arch Surg 2009; 144:575-81; discussion 581. PubMed
  • Ferrone CR,Correa-Gallego C,Warshaw AL,Brugge WR,Forcione DG,Thayer SP,Fernandez-del Castillo C. Current trends in pancreatic cystic neoplasms. Arch Surg 2009; 144:448-54. PubMed
  • Fritz S,Fernandez-del Castillo C,Mino-Kenudson M,Crippa S,Deshpande V,Lauwers GY,Warshaw AL,Thayer SP,Iafrate AJ. Global genomic analysis of intraductal papillary mucinous neoplasms of the pancreas reveals significant molecular differences compared to ductal adenocarcinoma. Ann Surg 2009; 249:440-7. PubMed
  • Correa-Gallego C,Warshaw AL,Fernandez-del Castillo C. Fluid CEA in IPMNs: A useful test or the flip of a coin? Am J Gastroenterol 2009; 104:796-7. PubMed
  • Fritz S,Warshaw AL,Thayer SP. Management of mucin-producing cystic neoplasms of the pancreas. Oncologist 2009; 14:125-36. PubMed
  • LaFemina J,Roberts PA,Hung YP,Gusella JF,Sahani D,Fernandez-del Castillo C,Warshaw AL,Thayer SP. Identification of a novel kindred with familial pancreatitis and pancreatic cancer. Pancreatology 2009; 9:273-9. PubMed
  • Keck T,Marjanovic G,Fernandez-del Castillo C,Makowiec F,Schafer AO,Rodriguez JR,Razo O,Hopt UT,Warshaw AL. The inflammatory pancreatic head mass: significant differences in the anatomic pathology of German and American patients with chronic pancreatitis determine very different surgical strategies. Ann Surg 2008; 249:105-10. PubMed
  • Ferrone CR,Warshaw AL,Rattner DW,Berger D,Zheng H,Rawal B,Rodriguez R,Thayer SP,Fernandez-del Castillo C. Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates. J Gastrointest Surg 2008; 12:1691-7; discussion 1697-8. PubMed
  • Dominguez I, Crippa S, Thayer SP, Hung YP, Ferrone CR, Warshaw AL, Fernandez-Del Castillo C. Preoperative Platelet Count and Survival Prognosis in Resected Pancreatic Ductal Adenocarcinoma. World J Surg 2008; 32:1051-6. PubMed
  • Bordeianou L,Vagefi PA,Sahani D,Deshpande V,Rakhlin E,Warshaw AL,Fernandez-del Castillo C. Cystic pancreatic endocrine neoplasms: a distinct tumor type? J Am Coll Surg 2008; 206:1154-8. PubMed
  • Crippa S, Dominguez I, Rodriguez JR, Razo O, Thayer SP, Ryan DP, Warshaw AL, Fernandez-Del Castillo C. Quality of life in pancreatic cancer: analysis by stage and treatment. J Gastrointest Surg 2008; 12:783-94. PubMed
  • Buchler MW, Warshaw AL. Resection versus drainage in treatment of chronic pancreatitis. Gastroenterology 2008; 134:1605-7. PubMed
  • Crippa S, Salvia R, Warshaw AL, Dominguez I, Bassi C, Falconi M, Thayer SP, Zamboni G, Lauwers GY, Mino-Kenudson M, Capelli P, Pederzoli P, Castillo CF. Mucinous cystic neoplasm of the pancreas is not an aggressive entity: lessons from 163 resected patients. Ann Surg 2008; 247:571-9. PubMed
  • Duerr EM, Mizukami Y, Ng A, Xavier RJ, Kikuchi H, Deshpande V, Warshaw AL, Glickman J, Kulke MH, Chung DC. Defining molecular classifications and targets in gastroenteropancreatic neuroendocrine tumors through DNA microarray analysis. Endocr Relat Cancer 2008; 15:243-56. PubMed
  • Rodriguez JR, Razo AO, Targarona J, Thayer SP, Rattner DW, Warshaw AL, Fernandez-del Castillo C. Debridement and closed packing for sterile or infected necrotizing pancreatitis: insights into indications and outcomes in 167 patients. Ann Surg 2008; 247:294-9. PubMed
  • Schnelldorfer T, Adams DB, Warshaw AL, Lillemoe KD, Sarr MG. Forgotten pioneers of pancreatic surgery: beyond the favorite few. Ann Surg 2007; 247:191-202. PubMed
  • Nikfarjam M, Warshaw AL, Axelrod L, Deshpande V, Thayer SP, Ferrone CR, Fernandez-del Castillo C. Improved contemporary surgical management of insulinomas: a 25-year experience at the Massachusetts General Hospital. Ann Surg 2007; 247:165-72. PubMed
  • Strobel O, Dor Y, Alsina J, Stirman A, Lauwers G, Trainor A, Castillo CF, Warshaw AL, Thayer SP. In vivo lineage tracing defines the role of acinar-to-ductal transdifferentiation in inflammatory ductal metaplasia. Gastroenterology 2007; 133:1999-2009. PubMed
  • Rodriguez JR, Salvia R, Crippa S, Warshaw AL, Bassi C, Falconi M, Thayer SP, Lauwers GY, Capelli P, Mino-Kenudson M, Razo O, McGrath D, Pederzoli P, Fern. Branch-duct intraductal papillary mucinous neoplasms: observations in 145 patients who underwent resection. Gastroenterology 2007; 133:72-9; quiz 309-10. PubMed
  • Crippa S, Bassi C, Warshaw AL, Falconi M, Partelli S, Thayer SP, Pederzoli P, Fernandez-del Castillo C. Middle pancreatectomy: indications, short- and long-term operative outcomes. Ann Surg 2007; 246:69-76. PubMed
  • Rodr. Distal pancreatectomy with splenic preservation revisited. Surgery 2007; 141:619-25. PubMed
  • Vagefi PA, Razo O, Deshpande V, McGrath DJ, Lauwers GY, Thayer SP, Warshaw AL, Fern. Evolving patterns in the detection and outcomes of pancreatic neuroendocrine neoplasms: the Massachusetts General Hospital experience from 1977 to 2005. Arch Surg 2007; 142:347-54. PubMed
  • Strobel O, Dor Y, Stirman A, Trainor A, Fern. Beta cell transdifferentiation does not contribute to preneoplastic/metaplastic ductal lesions of the pancreas by genetic lineage tracing in vivo. Proc Natl Acad Sci U S A 2007; 104:4419-24. PubMed
  • Ferrone CR, Finkelstein DM, Thayer SP, Muzikansky A, Fernandez-delCastillo C, Warshaw AL. Perioperative CA19-9 levels can predict stage and survival in patients with resectable pancreatic adenocarcinoma. J Clin Oncol 2006; 24:2897-902. PubMed
  • Rodr. Implications and cost of pancreatic leak following distal pancreatic resection. Arch Surg 2006; 141:361-5; discussion 366. PubMed
  • Fern. Serum CA 19-9 in the management of cystic lesions of the pancreas. Pancreas 2006; 32:220. PubMed
  • Bendell JC, Lauwers GY, Willett C, Clark JW, Warshaw AL, Wain JC, Ryan DP. Pancreatoblastoma in a teenage patient. Clin Adv Hematol Oncol 2006; 4:150-3; discussion 154. PubMed
  • Nehra D, Oyarvide VM, Mino-Kenudson M, Thayer SP, Ferrone CR, Wargo JA, Muzikansky A, Finkelstein D, Warshaw AL, Castillo CF. Intraductal papillary mucinous neoplasms: does a family history of pancreatic cancer matter? Pancreatology 2012; 12:358-63. PubMed