Stages of pancreatic neuroendocrine tumours (pNETs)

Many pancreatic neuroendocrine tumours (pNETs) are staged differently than other pancreatic cancers.

The staging system used for pNETs is the TNM system. For pNETs there are 4 stages. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

Only grade 1 (G1) and grade 2 (G2) well-differentiated pNETs are staged using the following classification. The grade describes how fast the tumour cells are growing.

Find out more about staging cancer and grading NETs.

Stage 1

The tumour is 2 cm or smaller. It is only in the pancreas or has grown into fat tissue around the pancreas.

Stage 2

The tumour is larger than 2 cm and is only in the pancreas or has grown into fat tissue around the pancreas. Or the tumour has grown into the duodenum or bile duct.

Stage 3

The tumour has grown into nearby tissues or organs around the pancreas. Or the cancer has spread to nearby lymph nodes.

Stage 4

The cancer has spread to other parts of the body (called distant metastasis), such as to the liver. This is also called metastatic neuroendocrine cancer.

Recurrent pNETs

Recurrent pNETs means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

Expert review and references

  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.