{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:58:31Z","timestamp":1776358711090,"version":"3.51.2"},"reference-count":190,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T00:00:00Z","timestamp":1637884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Pancreatic neuroendocrine neoplasms (panNENs) are a heterogeneous group of tumors derived from cells with neuroendocrine differentiation. They are considered malignant by default. However, their outcomes are variable depending on their presentation in the onset of hereditary syndromes, hormonal secretion, grading, and extension. Therefore, although surgical treatment has long been suggested as the only treatment of pancreatic neuroendocrine neoplasms, its modalities are an evolving landscape. For selected patients (small, localized, non-functional panNENs), a \u201cwait and see\u201d strategy is suggested, as it is in the setting of multiple neuroendocrine neoplasia type 1, but the accurate size cut-off remains to be established. Parenchyma-sparring pancreatectomy, aiming to limit pancreatic insufficiency, are also emerging procedures, which place beyond the treatment of insulinomas and small non-functional panNENs (in association with lymph node picking) remains to be clarified. Furthermore, giving the fact that the liver is generally the only metastatic site, surgery keeps a place of choice alongside medical therapies in the treatment of metastatic disease, but its modalities and extensions are still a matter of debate. This narrative review aims to describe the current recommended surgical management for pancreatic NENs and controversies in light of the actual recommendations and recent literature.<\/jats:p>","DOI":"10.3390\/cancers13235954","type":"journal-article","created":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T22:19:16Z","timestamp":1638137956000},"page":"5954","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["What Are the Place and Modalities of Surgical Management for Pancreatic Neuroendocrine Neoplasms? A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Samuel","family":"Frey","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Nantes, Quai de Tourville, 44000 Nantes, France"},{"name":"L\u2019institut du Thorax, Universit\u00e9 de Nantes, CNRS, INSERM, CHU de Nantes, 44000 Nantes, France"},{"name":"Chirurgie Canc\u00e9rologique, Digestive et Endocrinienne, Institut des Maladies de l\u2019Appareil Digestif, CHU de Nantes, 44000 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Miralli\u00e9","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Nantes, Quai de Tourville, 44000 Nantes, France"},{"name":"Chirurgie Canc\u00e9rologique, Digestive et Endocrinienne, Institut des Maladies de l\u2019Appareil Digestif, CHU de Nantes, 44000 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u00eblle","family":"Le Bras","sequence":"additional","affiliation":[{"name":"Endocrinologie, Diab\u00e9tologie et Nutrition, L\u2019institut du Thorax, CHU Nantes, 44000 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Regenet","sequence":"additional","affiliation":[{"name":"Chirurgie Canc\u00e9rologique, Digestive et Endocrinienne, Institut des Maladies de l\u2019Appareil Digestif, CHU de Nantes, 44000 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1007\/s12020-017-1273-x","article-title":"Increased incidence trend of low-grade and high-grade neuroendocrine neoplasms","volume":"58","author":"Leoncini","year":"2017","journal-title":"Endocrine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.ejso.2007.07.209","article-title":"Pancreatic neuroendocrine tumours","volume":"34","author":"Conlon","year":"2008","journal-title":"Eur. 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