Pancreatic neuroendocrine tumor (pNET), well-differentiated G1/G2
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DIS-PNET |
|---|---|
| Type | Disease |
| Aliases | Functional pNET (insulinoma, gastrinoma, glucagonoma, VIPoma)Non-functional pNETPancreatic islet cell tumorPancreatic neuroendocrine tumorpNETНейроендокринна пухлина підшлункової залози (пНЕП), добре-диференційована G1/G2 |
| Status | reviewed 2026-05-03 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-NET-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 8240/3 |
|---|---|
| icd_o_3_topography | ["C25"] |
| icd_10 | C25.4 |
| who_classification | WHO Classification of Digestive System Tumours 5th ed (2019): Pancreatic neuroendocrine tumour G1 (Ki67 <3%), G2 (3–20%), G3 (>20% but well-differentiated) |
Notes
Well-differentiated pNET G1/G2 is the dominant subtype in clinical practice (non-functional, discovered incidentally or via abdominal mass/liver mets). Grading per WHO 2019: G1 Ki67 <3%, G2 Ki67 3–20%. G3 well-differentiated pNET (Ki67 >20%) occupies a grey zone — still well-differentiated morphologically but higher proliferation; NCCN recommends everolimus/sunitinib/SSA ± chemo; not modelled separately here (flagged via RF-NET-HIGH-GRADE-G3 for MDT review). Distinguishing from poorly differentiated NEC (ICD-O 8246/3) is essential: NEC requires platinum-etoposide chemotherapy (not SSA/TKI/mTOR). Key trials: RADIANT-3 (everolimus, Yao NEJM 2011), Raymond 2011 (sunitinib), CLARINET pNET subgroup (lanreotide). Surgery remains the only curative option for localized disease.
Used By
Actionability
BMA-CHROMOGRANIN-A-NET-MEN1-SURVEILLANCE- Chromogranin A (CgA) is a granin-family secretory protein expressed ubiquitously in neuro...
Algorithms
ALGO-MEN1-CARRIER-SURVEILLANCE- ALGO-MEN1-CARRIER-SURVEILLANCEALGO-PNET-METASTATIC-1L- ALGO-PNET-METASTATIC-1LALGO-VHL-CARRIER-SURVEILLANCE-VHL-ALLIANCE- ALGO-VHL-CARRIER-SURVEILLANCE-VHL-ALLIANCE
Disease
DIS-GI-NET- Gastroenteropancreatic neuroendocrine tumor — GI origin (carcinoid), well-differentiated G1/G2DIS-PARATHYROID-CARCINOMA- Parathyroid carcinomaDIS-PITUITARY-ADENOMA- Pituitary adenoma
Indication
IND-MEN1-CARRIER-INTENSIFIED- IND-MEN1-CARRIER-INTENSIFIEDIND-MEN1-CARRIER-SURVEILLANCE- IND-MEN1-CARRIER-SURVEILLANCEIND-MEN1-SUSPICION-PREVENTION-ENHANCED-SURVEILLANCE- IND-MEN1-SUSPICION-PREVENTION-ENHANCED-SURVEILLANCEIND-MEN1-SUSPICION-PREVENTION-GENETIC-COUNSELING- IND-MEN1-SUSPICION-PREVENTION-GENETIC-COUNSELINGIND-MEN4-CARRIER-INTENSIFIED- IND-MEN4-CARRIER-INTENSIFIEDIND-MEN4-CARRIER-SURVEILLANCE- IND-MEN4-CARRIER-SURVEILLANCEIND-PNET-METASTATIC-1L-EVEROLIMUS- IND-PNET-METASTATIC-1L-EVEROLIMUS
Procedures
PROC-NEPHRON-SPARING-PARTIAL-NEPHRECTOMY-VHL- Nephron-sparing partial nephrectomy for VHL renal lesion (≥3 cm threshold)
Questionnaires
QUEST-PNET-1L-STUB- Pancreatic neuroendocrine tumor — first line
Red flag
RF-MEN1-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in the MEN1 (menin) gene. Patie...RF-MEN1-FAMILY-HISTORY-SUSPICION- Family pedigree suggestive of Multiple Endocrine Neoplasia type 1 (MEN1, Wermer syndrome)...RF-MEN4-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in CDKN1B (p27/Kip1) — Multiple...RF-NET-CARCINOID-SYNDROME- Active carcinoid syndrome in a patient with metastatic or unresectable GI-NET (or other s...RF-NET-HIGH-GRADE-G3- Well-differentiated or poorly-differentiated neuroendocrine tumor with Ki67 >20% (WHO 201...
Sources
SRC-CLARINET-CAPLIN-2014- Lanreotide in Metastatic Enteropancreatic Neuroendocrine Tumors (CLARINET; phase III)SRC-NCCN-NET-2025- NCCN Neuroendocrine and Adrenal TumorsSRC-RADIANT3-YAO-2011- Everolimus for Advanced Pancreatic Neuroendocrine Tumors (RADIANT-3; phase III)