Pancreatic Neuroendocrine Tumors: From Benchside to Surgical Treatment - PubMed

4 hours ago

Pancreatic neuroendocrine tumors (pNETs) are rare tumors with increasing incidence due to better diagnostics, showing higher prevalence in Western populations and links to metabolic disorders.
The 2022 WHO classification differentiates between well-differentiated NETs and poorly differentiated NECs using Ki-67 and mitotic indices, guiding prognosis and treatment.
Non-functional pNETs often present late, while functional tumors cause hormonal syndromes, requiring tailored approaches based on symptoms and tumor type.
Advanced imaging techniques like contrast-enhanced CT/MRI and 68Ga-DOTATATE PET, along with endoscopic ultrasound-guided biopsy, enable accurate tumor localization and grading.
Surgical resection is curative for localized disease, with minimally invasive methods reducing morbidity; active surveillance is recommended for small, low-grade, non-functional tumors (<2 cm).
For larger or aggressive tumors, resection is necessary; systemic therapies such as mTOR inhibitors (e.g., everolimus), anti-angiogenics (e.g., surufatinib), and peptide receptor radionuclide therapy (PRRT) improve survival in advanced cases, though immunotherapy has limited efficacy.
Future management focuses on molecular profiling, biomarker development, and multidisciplinary integration to enhance precision medicine, balancing cancer control with quality of life and functional preservation.

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