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Data on their presentation, management, and outcomes remain limited. This retrospective study analyzed 28 pediatric panNET cases from the German Malignant Endocrine Tumor (MET) Registry enrolled between 1997 and 2024. Clinical presentation, diagnostics, and treatment were evaluated to identify prognostic factors and outcomes. The cohort included 18 females (64.3%) and 10 males (35.7%), with a median age at diagnosis of 14.7\u2009years. Nonfunctional tumors predominated (75%). Genetic syndromes were identified in 17.9% of patients. Localized disease showed a 3\u2010year overall survival (OS) of 100%, while metastatic disease had a 3\u2010year OS of 50.9%. Event\u2010free survival was significantly associated with the presence of distant metastases (M0 vs. M1,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.0082) and complete surgical resection (R\n                    <jats:sub>0<\/jats:sub>\n                    vs. R\n                    <jats:sub>1\/2<\/jats:sub>\n                    vs. no resection,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.0077) but not with lymph node involvement (N0 vs. N1,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.12), tumor localization within the pancreas (head vs. body vs. tail,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.86), the extent of the primary tumor (pT1\u20102 vs. pT3\u20104,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20091.0), pathological grade (G1 vs. G2\u20103,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.28), or proliferation index (Ki67\u2009\u2264\u200910% vs. &gt;10%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.11). This study underscores the importance of disease stage and surgical resection as key prognostic factors in pediatric panNETs. It highlights the need for pediatric\u2010specific management guidelines, integration of genetic screening, and expanded molecular profiling to optimize outcomes for children and adolescents with panNETs.\n                  <\/jats:p>","DOI":"10.1111\/jne.70039","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T09:14:40Z","timestamp":1748337280000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Pancreatic neuroendocrine tumors in children and adolescents\u2014Data from the German\n                    <scp>MET<\/scp>\n                    studies (1997\u20132023)"],"prefix":"10.1111","volume":"37","author":[{"given":"Katharina","family":"Karges","sequence":"first","affiliation":[{"name":"Pediatrics and Adolescent Medicine, Faculty of Medicine University of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2672-4045","authenticated-orcid":false,"given":"Marina","family":"Kunstreich","sequence":"additional","affiliation":[{"name":"Pediatrics and Adolescent Medicine, Faculty of Medicine University of Augsburg  Augsburg Germany"},{"name":"Department of Pediatrics, Pediatric Hematology\/Oncology Otto\u2010von\u2010Guericke\u2010University  Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5238-8348","authenticated-orcid":false,"given":"Ulrich\u2010Frank","family":"Pape","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Gastroenterology Asklepios Klinik St. Georg, Asklepios Tumorzentrum  Hamburg 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik T.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Clinic of Pediatrics Dortmund Municipal Hospital, University Witten\/Herdecke  Witten Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines B.","family":"Brecht","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology University Children's Hospital, Eberhard\u2010Karls University  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Lapa","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Faculty of Medicine University of Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8237-1854","authenticated-orcid":false,"given":"Michael C.","family":"Fr\u00fchwald","sequence":"additional","affiliation":[{"name":"Pediatrics and Adolescent Medicine, Faculty 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