Where do pancreatic neuroendocrine tumors metastasize
While pancreatic neuroendocrine tumors can metastasize to any organ in the body, the most common organ is metastasis to the liver.

Pancreatic neuroendocrine tumors can metastasize to any organ in the body; however, the most common organ is the liver.

If a pancreatic neuroendocrine tumor spreads to the liver, it is called a pancreatic neuroendocrine tumor with metastasis to the liver and not liver cancer.

People can live without a fully functional pancreas but not without a liver. Liver failure resulting from metastasis from these tumors is the most common cause of death in patients affected by the tumor.

How do doctors determine the prognosis of pancreatic neuroendocrine tumors?

After the diagnosis of a pancreatic neuroendocrine tumor has been confirmed, the doctor must determine the stage and grade of cancer. This helps them decide the course of treatment and estimate the chances of survival.

Staging of cancer

Staging is done based on how far cancer has spread. Cancer can be staged I, II, III, or IV. The number indicates the extent of the spread of cancer. The higher the number, the more cancer has spread.

Grading the cancer

Grading lets the doctor know how different the cancer cells look from normal cells. This provides an idea about the speed of growth and spread of cancer. The tumor will be given a grade between I and III. A lower number indicates slow-growing cancer.

What is the life expectancy of someone with pancreatic neuroendocrine cancer?

The lifespan of a patient with a pancreatic neuroendocrine tumor depends on the stage and grade of their cancer. Studies that have observed patients with pancreatic neuroendocrine tumors for five years and more provide an estimate of the number of people living with the tumor for at least five years. This is known as a five-year survival rate.

Table. The five-year survival rate of pancreatic neuroendocrine tumor
Stage of tumor 5-year survival rate (in percentage)
Localized 93
Regional 77
Metastatic 25

Localized tumor: This refers to the tumor that has not spread to other parts of the body from where it started. The five-year survival rate for people with localized pancreatic neuroendocrine tumors is 93 percent, which means 93 percent of patients can expect to live for five years or more.

Regional tumor: This refers to the tumor that has spread to nearby tissue or the regional lymph nodes. The five-year survival rate for regional pancreatic neuroendocrine tumors is 77 percent.

Metastatic tumor: If the tumor has spread to distant areas of the body, such as the liver, the survival rate is 25 percent.

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How is pancreatic neuroendocrine tumor treated?

To decide the best treatment, the doctor will first assess the following factors:

  • The stage and grade of the cancer
  • Age of the patient
  • Other health problems that the patient has
  • The patient’s preferences

Treatments are available for all stages of cancer. Even the advanced stage of cancer will benefit from treatments to relieve symptoms.

The types of treatments to treat pancreatic neuroendocrine cancer include:

Surgery

Surgery is preferred if the pancreatic neuroendocrine tumor is restricted only to the pancreas. The surgery will involve removing a part or most of the pancreas. If cancer has spread beyond the pancreas, surgery may not help and other treatments may be preferred.

Tumor ablation and embolization

Tumor ablation or embolization is done if a pancreatic neuroendocrine tumor has spread to the liver. It destroys the tumor and may be done in any of the following ways:

  • Killing the tumor cells with radio waves or microwaves
  • Freezing and destroying the tumor cells (cryoablation)
  • Blocking the blood supply to the tumor

Chemotherapy

Chemotherapy involves using drugs that kill the cancer cells. Given in either the form of pills or injections, these drugs are taken in multiple sessions lasting months or years with intervals in between.

Radiotherapy

This therapy uses strong radiation that targets the tumor and shrinks it. It may be given after surgery to destroy the remaining part of the tumor.

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Medically Reviewed on 9/23/2021
References
Ong ES. Neoplasms of the Endocrine Pancreas. https://emedicine.medscape.com/article/276943-overview

American Cancer Society. Survival Rates for Pancreatic Neuroendocrine Tumor. https://www.cancer.org/cancer/pancreatic-neuroendocrine-tumor/detection-diagnosis-staging/survival-rates.html