Gastroenteropancreatic neuroendocrine neoplasms: A clinical snapshot

Table 4 Tumor-node-metastasis staging of pancreatic neuroendocrine neoplasms based on the American Joint Committee on Cancer and the European Neuroendocrine Tumor Society (modified European Neuroendocrine Tumor Society staging)[80] and tumor-node-metastasis staging of the small intestinal neuroendocrine neoplasms based on American Joint Committee on Cancer[81]

	TNM staging of pancreatic neuroendocrine tumours					TNM staging of small intestinal neuroendocrine tumours
T0						No documented evidence of a primary tumour
T1	Tumour limited to pancreas, ≤ 2 cm					Tumour invading lamina propria/submucosa, and size ≤ 1 cm
T2	Tumour limited to pancreas, 2-4 cm					Tumour invading muscularis propria or size ≥ 1 cm
T3	Tumour limited to pancreas, > 4 cm, or invading duodenum/bile duct					Tumour invading sub-serosa (without penetrating the serosa)
T4	Tumour invades adjacent structures					Tumour invading peritoneum/other organs/adjacent structures
N0	Absence of regional lymph node metastasis					Absence of regional lymph node metastasis
N1	Presence of regional lymph node metastasis					Presence of regional lymph node metastasis in < 12 nodes
N2	Absence of distant metastasis					Presence of large mesenteric masses (> 2 cm) or ≥ 12 nodes
M0	Presence of distant metastasis					Absence of distant metastasis
M1	Metastasis confined to hepatic tissue					Presence of distant metastasis
M1a	Metastasis in at least one extrahepatic tissue					Metastasis confined to hepatic tissue
M1b	Both hepatic and extrahepatic metastatic involvement					Metastasis in at least one extrahepatic tissue
M1c	Tumour limited to pancreas, ≤ 2 cm					Both hepatic and extrahepatic metastatic involvement
Stage IA	Stage IB	Stage IIA	Stage IIB	Stage III	Stage IV	Stage I	STAGE IIA	Stage IIB	Stage IIIA	Stage IIIB	Stage IV
T1N0M0	T2N0M0	T3N0M0	T1-3N1M0	T4NanyM0	TanyNanyM1	T1N0M0	T2N0M0	T3N0M0	T4N0M0	TanyN0M0	TanyNanyM1

TNM: Tumor-node-metastasis.