Predictors of disease progression in pancreatic neuroendocrine tumors after surgery

Pancreatic neuroendocrine tumors (pNETs) are a heterogeneous group of tumors that exhibit a range of biological behaviors, from indolent to aggressive. Identifying prognostic factors for pNETs is essential for risk stratification and personalized treatment planning. Clinicopathological data of stage I to III patients who underwent pancreatic resection and were treated for pNET at an ENETS Center of Excellence from 2009 to 2023 were analyzed retrospectively. 89 pNET patients were included (45 female, 44 male). Proximal pNETs had higher proportions of lymph node metastases (48.4% vs. 17.2%, p = 0.002) and shorter progression-free survival (PFS) compared to distal tumors (5-year PFS 56.2% vs. 85.0%, p = 0.003). Subdivision of G2 into G2a (Ki67 3-