Prognostic factors for pancreatic neuroendocrine neoplasms (pNET) and the risk of small non-functioning pNET

Abstract

Among NF-pNET, large neoplasms were associated with worse outcomes; however, small NF-pNET do not seem to have an invariable benign behavior. Whether surgery should be avoided in all patients with small NF-pNET is questionable.

Pancreaticoduodenectomy and metastasectomy for metastatic pancreatic neuroendocrine tumors

“…Tumor grade is well established as a meaningful prognostic marker in PNETs . Grade has been shown to be independently associated with survival time in patients with PNET, with high‐grade tumors having the most aggressive tumor biology, leading to worse survival outcomes . Given its prognostic significance, we stratified patients according to grade comparing survival time of patients with low‐, intermediate‐, and high‐grade primary PNETs.…”

“…16 Grade has been shown to be independently associated with survival time in patients with PNET, with high-grade tumors having the most aggressive tumor biology, leading to worse survival outcomes. 3,17 Given its prognostic significance, we stratified patients according to…”

Glycemic control in patients with insulinoma

“…Chemotherapy and peptide receptor radionuclide therapy (PRRT) are also considered important therapeutic options. 6,61 Cytoreductive surgery in advanced malignant insulinoma contributes to improved glycemic control and renders systemic therapy more effective. Therefore, palliative surgery to remove or debulk the primary tumor is recommended.…”

Unmet Needs in Functional and Nonfunctional Pancreatic Neuroendocrine Neoplasms

“…Only recently is this approach being increasingly used in patients with sporadic, asymptomatic NF-PanNENs [19-21, 23, 48]. This recommendation is not without controversy, with some authors advocating surgery for all PanNENs, whereas others support the conclusion that small, asymptomatic PanNENs are good candidates for surveillance [19-21, 49-52]. …”