The Role of Surgery for Pancreatic Neuroendocrine Tumors

Anticancer Res. 2022 Feb;42(2):629-639. doi: 10.21873/anticanres.15520.


Pancreatic neuroendocrine tumors (PNETs) arise from endocrine pancreatic cells and comprise 3-5% of pancreatic cancers. Surgical resection is the only potentially curative option for PNETs. Surgical candidates should be carefully selected according to tumor functionality, size, location, grade, and stage. Current guidelines state that patients with neuroendocrine carcinoma may not be surgical candidates due to aggressive tumor behavior and poor prognosis, while in cases of PNET with unresectable metastatic disease, resection may be of benefit in certain patients. The current guidelines recommend resection of any size of functional PNETs and of non-functional PNETs >2 cm. Watchful waiting is recommended for patients with non-functional PNETs <1 cm. Further evidence is needed to determine whether surgery for non-functional PNETs of 1-2 cm would be of benefit or if surgery should be individualized. This review aimed to discuss the current literature on the management of PNETs and highlight the utility of surgery in treatment.

Keywords: PNET; Pancreatic neuroendocrine tumor; neuroendocrine carcinoma; resection; review; surgery.

Publication types

  • Review

MeSH terms

  • Humans
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Minimally Invasive Surgical Procedures
  • Neoplasm Grading
  • Neoplasm Staging
  • Neuroendocrine Tumors / diagnosis
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery*
  • Pancreatectomy
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Patient Selection
  • Treatment Outcome