Resection versus expectant management of small incidentally discovered nonfunctional pancreatic neuroendocrine tumors
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Published on: January 2, 2026
Alex M Rosenberg1, Patricia Friedmann1, Jaydira Del Rivero2
1Albert Einstein College of Medicine, Bronx, NY.
Background:
Sporadic, nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) are diagnosed with increasing frequency. We compared the risk of tumor growth, metastasis, and mortality between patients treated versus those treated expectantly.
Method:
A retrospective study of patients seen at our institution with sporadic NF-PNETs, with ≥ 12 months of follow-up. Kaplan-Meier analysis was performed.
Results:
Between 1999 and 2014, 35 patients with an incidentally discovered nonfunctional PNET were identified. Twenty underwent resection and 15 were followed with imaging. In the operative group, 8 had NF-PNETs < 2 cm, while 12 had NF-PNETs ≥ 2 cm. In the nonoperative expectant management by serial imaging group, 10 had NF-PNETs < 2 cm while 5 had NF-PNETs ≥ 2 cm. Small NF-PNETs (<2 cm) in either the operative or nonoperative groups demonstrated no evidence of progression or metastasis (median follow-up of 27.8 months). Morbidity in the operative group was 35% with pancreatic pseudocyst the most common.
Conclusion:
Incidentally discovered NF-PNETs < 2 cm in size can be observed safely with serial imaging.
