INTRODUCTIONPancreatic neuroendocrine tumors (PNETs) are relatively rare, but increased detection through imaging of these tumors and subsequent studies have led to an increased understanding of their biologic behavior, which resulted in new diagnostic terminology and a new grading system by the World Health Organization (WHO) in 2010 based on the European Neuroendocrine Tumor Society (ENETS) classification. It has been demonstrated that the WHO grading system is a meaningful prognostic indicator for assessing the clinical outcome of patients who undergo surgical resection of PNETs. Before surgical resection, most PNETs are diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration (FNA) biopsy. Grading of PNETs on FNA, as on surgical resection, is becoming the standard of care, mainly to guide surgical management. The revised 2016 ENETS guidelines recommend curative resection of nonfunctional PNETs in the absence of nonresectable metastases. The possibility of nonoperative management has been investigated for patients who have asymptomatic, sporadic PNETs measuring <2 cm with favorable outcomes, but long‐term follow‐up data are lacking to cement those findings into current practice. Our institution has incorporated grading into the patient‐evaluation algorithm, in conjunction with the updated National Comprehensive Cancer Network (NCCN) guidelines. The 2017 NCCN cancer guidelines incorporate the finding that observation can be
Cancer Cytopathology – Wiley
Published: Jan 1, 2018
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