Stages of neuroendocrine cancer

Last medical review:

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

Staging NETs depends on where the cancer started.

Neuroendocrine tumours (NETs)

Some types of neuroendocrine tumours (NETs) have their own staging systems. Other types are staged using the system that is also used for other cancers that start in the same part of the body.

Gastrointestinal neuroendocrine tumours (GI NETs) are staged differently than most other types of GI cancer. GI NETs of the stomach, small intestine, colon, rectum and appendix have their own unique staging. Find out more about stages of GI NETs.

Lung neuroendocrine tumours (lung NETs) are staged using the same system that is used for non–small cell lung cancer. Find out more about stages of non–small cell lung cancer.

Pancreatic neuroendocrine tumours (pNETs) are staged differently than most other pancreatic cancers. Find out more about stages of pNETs.

There are other types of NETs. Talk to your doctor to learn more about the stages for specific types of NETs.

Neuroendocrine carcinomas (NECs)

Most neuroendocrine carcinomas (NECs) are staged using the same system as other cancers that start in the same part of the body. Some less common types of NECs have their own staging system.

Pancreatic neuroendocrine carcinoma (pNEC) is staged using the same system as other pancreatic cancers. Find out more about stages of pancreatic cancer.

Small cell lung carcinoma (small cell lung cancer) has its own staging system. It can also be staged using the same system as other lung cancers but this is less common. Find out more about staging small cell lung cancer.

Medullary thyroid carcinoma is staged using the staging system for thyroid cancer. It has its own stage grouping in the system. Find out more about stages of thyroid cancer.

Merkel cell carcinoma is staged differently than other skin cancers and has its own staging system.

There are other types of NECs. Talk to your doctor to learn more about the stages for specific types of NECs.

Expert review and references

  • Sylvia Asa, MD, PhD
  • Cancer Research UK. Stages and Grades of Pancreatic NETs. 2021. https://www.cancerresearchuk.org/.
  • Cancer Research UK. Stages, Types and Grades of Lung NETs . 2021. https://www.cancerresearchuk.org/.
  • Canadian Neuroendocrine Tumour Society (CNETS). Neuroendocrine Tumours: Reference Guide for Patients and Families (Version 3). 2020. https://cnets.ca/.
  • Canadian Neuroendocrine Tumour Society (CNETS). Neuroendocrine Tumours: Reference Guide for Patients and Families (Version 3). 2020. https://cnets.ca/.
  • Macmillan Cancer Support. Staging and Grading of Neuroendocrine Tumours (NETs). 2022. https://www.macmillan.org.uk/.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine and Adrenal Tumors Version 2.2024. 2024.
  • Neuroendocrine Cancer UK. Neuroendocrine Cancer Virtual Patient Handbook. 2023. https://www.neuroendocrinecancer.org.uk/.
  • Pavel M, Öberg k, Falconi M, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2020: 31(7):844–860.
  • Rami-Porta R, Asamura H, Travis WD, Rusch VW. Lung. Amin, MB (ed.). AJCC Cancer Staging Manual. 8th ed. Chicago, IL: American College of Surgeons; 2017: 36:431–456.
  • Rindi G, Mete O, Uccella S, et al. Overview of the 2022 WHO classification of neuroendocrine neoplasms. Endocrine Pathology. 2022: 33(1):115–154.

Stages of gastrointestinal neuroendocrine tumours (GI NETs)

The staging of gastrointestinal neuroendocrine tumours (GI NETs) uses the TNM system. GI NETs are staged based on the organ where the cancer started.

Stages of pancreatic neuroendocrine tumours (pNETs)

The staging of pancreatic neuroendocrine tumours (pNETs) uses the TNM system. They are staged differently than other pancreatic cancers.

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