Clinical Focus

  • Cancer > Cutaneous (Dermatologic) Oncology
  • Cancer > GI Oncology
  • Melanoma Surgery
  • Endocrine - Surgery
  • Gastrointestinal Cancers
  • Gastrointestinal Cancers - Surgical Oncology
  • General Surgery
  • Pancreas Surgery
  • Pancreatic Cancer
  • Pancreatic Cancer - Surgery

Academic Appointments

Administrative Appointments

  • Professor of Surgery, Emeritus, Stanford University School of Medicine (2015 - Present)
  • Johnson & Johnson Distinguished Professor, Stanford University School of Medicine (2000 - 2015)
  • Director, General Surgery Residency Program, Stanford University School of Medicine (2000 - 2009)
  • Chief, Division of General Surgery, Stanford University School of Medicine (2000 - 2006)

Honors & Awards

  • Cum Laude Graduation Honors, Fordham University (1964)
  • The Wakely Prize - Runner up, The Lancet (1997)
  • The Parker J. Palmer Courage to Teach Award, Accreditation Council for Graduate Medical Education (ACGME) (2006)
  • The John C. Gienapp Award, Accreditation Council for Graduate Medical Education (ACGME) (2012)

Professional Education

  • Medical Education:Yale University School of Medicine (1968) CT
  • Residency:Yale - New Haven Hospital (1973) CT
  • Board Certification: General Surgery, American Board of Surgery (1974)
  • Internship:Yale - New Haven Hospital (1969) CT
  • MD, Yale Medical School (1968)
  • Fellow, American Cancer Society (1971)

Community and International Work

  • Board of Directors of Hopital Albert Schweitzer, Haiti


    International Health in Haiti



    Ongoing Project


    Opportunities for Student Involvement


Research & Scholarship

Current Research and Scholarly Interests

Application of Micro/Nanotechnology to Biological Systems.

Clinical Trials

  • Lymph Node Mapping Using Indocyanine Green Solution in Diagnosing Patients With Malignant Melanoma Not Recruiting

    This clinical trial studies lymph node mapping using indocyanine green solution in diagnosing patients with malignant melanoma. Diagnostic procedures, such as lymph node mapping using indocyanine green solution, may help find out how far the melanoma has spread and may help in planning cancer treatment.

    Stanford is currently not accepting patients for this trial. For more information, please contact Ralph S. Greco, 650-736-1355.

    View full details

  • Trilogy Stereotactic Body Radiotherapy for Pancreatic Cancer Not Recruiting

    This study will assess the efficacy of treating locally advanced pancreatic cancer using Stereotactic Body Radiotherapy (using Trilogy) and Gemcitabine

    Stanford is currently not accepting patients for this trial. For more information, please contact Jeff Kim, (650) 498 - 7703.

    View full details


All Publications

  • Promoting Balance in the Lives of Resident Physicians: A Call to Action. JAMA surgery Salles, A., Liebert, C. A., Greco, R. S. 2015; 150 (7): 607-608

    View details for DOI 10.1001/jamasurg.2015.0257

    View details for PubMedID 25992632

  • Indocyanine Green and Fluorescence Lymphangiography for Sentinel Lymph Node Identification in Cutaneous Melanoma JOURNAL OF SURGICAL ONCOLOGY Cloyd, J. M., Wapnir, I. L., Read, B. M., Swetter, S., Greco, R. S. 2014; 110 (7): 888-892

    View details for DOI 10.1002/jso.23745

    View details for Web of Science ID 000344552200020

  • Indocyanine green and fluorescence lymphangiography for sentinel lymph node identification in cutaneous melanoma. Journal of surgical oncology Cloyd, J. M., Wapnir, I. L., Read, B. M., Swetter, S., Greco, R. S. 2014; 110 (7): 888-892


    Sentinel lymph node (SLN) biopsy has become the standard method of determining regional lymph node involvement in cutaneous melanoma. Although traditionally performed via injection of radioisotope tracers and blue dyes, fluorescent lymphangiography with indocyanine green (ICG) is an attractive alternative.Fifty two consecutive patients with cutaneous melanoma of the trunk or extremities underwent SLNB. Preoperative lymphoscintigraphy was performed with technetium-99m sulfur colloid (TSC). Peritumoral intradermal injection of isosulfan blue (ISB) and ICG was then performed. Successful identification of a sentinel lymph node via each modality was then assessed.A total of 77 lymph nodes were identified from the 52 patients (range 1-3). The majority of melanomas were extremity-based, superficial spreading type, and had SLN localized to the axilla. There were no complications related to IcG administration. Rates of SLN detection were 96.2% for TSC, 59.6% for ISB, and 88.5% for IcG (P < 0.05 for ICG vs ISB). On univariate logistic regression analysis, no factors were found to be associated with failure of ICG.Fluorescent lymphangiography using ICG is an effective method of SLN identification in patients with cutaneous melanoma of the trunk and extremities. When ICG and TSC are used in combination, ISB offers no additional advantage and may be safely omitted. J. Surg. Oncol. © 2014 Wiley Periodicals, Inc.

    View details for DOI 10.1002/jso.23745

    View details for PubMedID 25124992

  • Health behaviors and needs of melanoma survivors. Supportive care in cancer Palesh, O., Aldridge-Gerry, A., Bugos, K., Pickham, D., Chen, J. J., Greco, R., Swetter, S. M. 2014; 22 (11): 2973-2980


    Little is known about melanoma survivors' long-term symptoms, sun protection practices, and support needs from health providers.Melanoma survivors treated at Stanford Cancer Center from 1995 through 2011 were invited to complete a heath needs survey. We compared responses of survivors by sex, education, time since diagnosis (long-term vs. short-term survivors), and extent of treatment received (wide local excision (WLE) alone versus WLE plus additional surgical or medical treatment (WLE+)).One hundred sixty melanoma survivors (51 % male; 61 % long-term; 73 % WLE+) provided evaluable data. On average, patients were 62 years of age (SD = 14), highly educated (75 % college degree), and Caucasian (94 %). Overall, participants rated anxiety as the most prevalent symptom (34 %). Seventy percent reported that their health provider did not address their symptoms, and 53 % requested education about melanoma-specific issues. Following treatment, women spent significantly less time seeking a tan compared with men (p = 0.01), had more extremity swelling (p = 0.014), and expressed higher need for additional services (p = 0.03). Long-term survivors decreased their use of tanning beds (p = 0.03) and time spent seeking a tan (p = 0.002) and were less likely to receive skin screening every 3-6 months (p < 0.001) compared with short-term survivors. WLE+ survivors reported greater physical long-term effects than WLE survivors (p ≤ 0.001) following treatment.Melanoma survivors experience continuing symptoms long after treatment, namely anxiety, and they express a need for information about long-term melanoma effects, psychosocial support, and prevention of further skin cancer.

    View details for DOI 10.1007/s00520-014-2286-0

    View details for PubMedID 24879390

  • Health behaviors and needs of melanoma survivors SUPPORTIVE CARE IN CANCER Palesh, O., Aldridge-Gerry, A., Bugos, K., Pickham, D., Chen, J. J., Greco, R., Swetter, S. M. 2014; 22 (11): 2973-2980
  • Symbiotic or Parasitic? A Review of the Literature on the Impact of Fellowships on Surgical Residents ANNALS OF SURGERY Plerhoples, T. A., Greco, R. S., Krummel, T. M., Melcher, M. L. 2012; 256 (6): 904-908


    We conducted a systematic review of published literature to gain a better understanding of the impact of advanced fellowships on surgical resident training and education.As fellowship opportunities rise, resident training may be adversely impacted.PubMed, MEDLINE, Scopus, BIOSIS, Web of Science, and a manual search of article bibliographies. Of the 139 citations identified through the initial electronic search and screened for possible inclusion, 23 articles were retained and accepted for this review. Data were extracted regarding surgical specialty, methodology, sample population, outcomes measured, and results.Eight studies retrospectively compared the eras before and after the introduction of a fellowship or trended data over time. Approximately half used data from a single institution, whereas the other half used some form of national data or survey. Only 3 studies used national case data. Fourteen studies looked at general surgery, 6 at obstetrics-gynecology, 2 at urology, and 1 at otolaryngology. Only one study concluded that fellowships have a generally positive impact on resident education, whereas 9 others found a negative impact. The remaining 13 studies found mixed results (n = 6) or minimal to no impact (n = 7).The overall impact of advanced surgical fellowships on surgical resident education and training remains unclear, as most studies rely on limited data of questionable generalizability. A careful study of the national database of surgery resident case logs is essential to better understand how early surgical specialization and fellowships will impact the future of general surgery education.

    View details for DOI 10.1097/SLA.0b013e318262edd5

    View details for Web of Science ID 000312261000012

    View details for PubMedID 22968071

  • Bilateral Adrenal Medullary Hyperplasia Associated With an SDHB Mutation JOURNAL OF CLINICAL ONCOLOGY Grogan, R. H., Pacak, K., Pasche, L., Huynh, T. T., Greco, R. S. 2011; 29 (8): E200-E202

    View details for DOI 10.1200/JCO.2010.32.2156

    View details for Web of Science ID 000288161000006

    View details for PubMedID 21172883

  • Massive Extra-adrenal Retroperitoneal Paraganglioma: Pre-operative Embolization and Resection DIGESTIVE DISEASES AND SCIENCES Rosing, J. H., Jeffrey, R. B., Longacre, T. A., Greco, R. S. 2009; 54 (8): 1621-1624

    View details for DOI 10.1007/s10620-009-0804-6

    View details for Web of Science ID 000267485400002

    View details for PubMedID 19408117

  • Fabrication of multi-layered biodegradable drug delivery device based on micro-structuring of PLGA polymers BIOMEDICAL MICRODEVICES Ryu, W. H., Vyakarnam, M., Greco, R. S., Prinz, F. B., Fasching, R. J. 2007; 9 (6): 845-853


    A programmable and biodegradable drug delivery device is desirable when a drug needs to be administered locally. While most local drug delivery devices made of biodegradable polymers relied on the degradation of the polymers, the degradation-based release control is often limited by the property of the polymers. Thus, we propose micro-geometry as an alternative measure of controlling drug release. The proposed devices consist of three functional layers: diffusion control layer via micro-orifices, diffusion layer, and drug reservoir layers. A micro-fabrication technology was used to shape an array of micro-orifices and micro-cavities in 85/15PLGA layers. A thin layer of fast degrading 50/50PLGA was placed as the diffusion layer between the 85/15PLGA layers to prevent any burst-type release. To modulate the release of the devices, the dimension and location of the micro-orifices were varied and the responding in vitro release response of tetracycline was monitored over 2 weeks. The release response to the different micro-geometry was prominent and further analyzed by FEM simulation. Comparison of the experiments to the simulated results identified that the variation of micro-geometry influenced also the volume-dependent degradation rate and induced the osmotic pressure.

    View details for DOI 10.1007/s10544-007-9097-8

    View details for Web of Science ID 000250462200009

    View details for PubMedID 17577671

  • The construction of three-dimensional micro-fluidic scaffolds of biodegradable polymers by solvent vapor based bonding of micro-molded layers BIOMATERIALS Ryu, W., Min, S. W., Hammerick, K. E., Vyakarnam, M., Greco, R. S., Prinz, F. B., Fasching, R. J. 2007; 28 (6): 1174-1184


    It is increasingly important to control cell growth into and within artificial scaffolds. Tissues such as skin, blood vessels, and cartilage have multi-layer structures with different cells in each layer. With the aid of micro-fabrication technology, a novel scaffolding method for biodegradable polymers such as polylactic acid (PLA), polyglycolic acid (PGA), and the copolymers poly(lactide-co-glycolide)(PLGA), was developed to construct three-dimensional multi-layer micro-fluidic tissue scaffolds. The method emphasizes micro-fluidic interconnections between layers within the scaffolds and maintenance of high-resolution geometries during the bonding process for the creation of multi-layered scaffolds. Micro-holes (10-100 microm), micro-channels, and micro-cavities were all created by micro-molding. Solvent-vapor based bonding of micro-molded layers preserved 20 microm sized structures. Sample scaffolds were constructed for purposes such as channel-directed cell growth and size-based cell sorting. Further extension of these techniques to create a micro-vascular network within or between layers is possible. Culturing of human coronary artery endothelial cells (HCAECs) on the sample scaffolds demonstrated the biocompatibility of the developed process and the strong influence of high-resolution micro-geometries on HCAEC growth.

    View details for DOI 10.1016/j.biomaterials.2006.11.002

    View details for Web of Science ID 000243219000028

    View details for PubMedID 17126395

  • Microfabrication technology of biodegradable polymers for interconnecting microstructures JOURNAL OF MICROELECTROMECHANICAL SYSTEMS Ryu, W., Fasching, R. J., Vyakarnam, M., Greco, R. S., Prinz, F. B. 2006; 15 (6): 1457-1465
  • Micro Fabrication Technology for Biodegradable Polymers for Interconnecting Microstructures Ryu WonHyoung, Fasching R, Vyakarnam M, Prinz F, Greco R S 2006
  • Nanotechnology Applied to Biological Systems Greco RS. 2004
  • Immunohistochemical profile of the sodium/iodide symporter in thyroid, breast, and other carcinomas using high density tissue microarrays and conventional sections JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM Wapnir, I. L., van de Rijn, M., Nowels, K., Amenta, P. S., Walton, K., Montgomery, K., Greco, R. S., Dohan, O., Carrasco, N. 2003; 88 (4): 1880-1888


    Extrathyroidal cancers could potentially be targeted with (131)I, if the Na(+)/I(-) symporter (NIS) were functional. Using immunohistochemical methods we probed 1278 human samples with anti-NIS antibody, including 253 thyroid and 169 breast conventional whole tissue sections (CWTS). Four high density tissue microarrays containing a wide variety of breast lesions, normal tissues, and carcinoma cores were tested. The results of the normal microarray were corroborated in 50 CWTS. Nineteen of 34 normal tissues, including bladder, colon, endometrium, kidney, prostate, and pancreas, expressed NIS. Nineteen of 25 carcinomas demonstrated NIS immunopositivity; 55.7% of 479 carcinoma microarray cores expressed NIS, including prostate (74%), ovary (73%), lung (65%), colon (62.6%), and endometrium (56%). NIS protein was present in 75% benign thyroid lesions, 73% thyroid cancers, 30% normal-appearing, peritumoral breasts, 88% ductal carcinomas in situ, and 76% invasive breast carcinoma CWTS. Comparatively, breast microarray cores had lower immunoreactivity. Plasma membrane immunopositivity was confirmed in thyrocytes, salivary ductal, gastric mucosa, and lactating mammary cells. In other tissues, immunoreactivity was predominantly intracellular, particularly in malignant lesions. Thus, NIS is present in many normal epithelial tissues and is predominantly expressed intracellularly in many carcinomas. Elucidating the regulatory mechanisms that render NIS functional in extrathyroidal carcinomas may make (131)I therapy feasible.

    View details for DOI 10.1210/jc.2002-021544

    View details for Web of Science ID 000182211000072

    View details for PubMedID 12679487

  • Neutrophil survival on biomaterials is determined by surface topography. J Vasc Surg. Chang S, Popowich Y, Greco RS, Haimovich B. 2003; 37 (5): 1082-90
  • PMN exposure to a quantified bacterial load leads to a rapid, non-apoptotic cell death. Surg Forum Popowich Y, Greco RS, Haimovich B. 2001; 87 (LII): 344-346
  • Dacron and ePTFE-associated neutrophil death is linked to surface to surface topography and involves activation of SRC and PYK tyrosine kinases. Surg Forum Chang SS, Haimovich B, Greco RS. 2000; 86 (LI): 404-407
  • The cardboard box JAMA Greco RS. 2000; 284 (5): 534
  • Neutrophil Adhesion to vascular prosthetic surfaces triggers non-apoptotic cell death. Ann Surg Nadzam G, De La Cruz C, Greco RS, Haimovich B. 2000; 231 (4): 587-599