[Current status and advances in adjuvant therapy after curative resection for pancreatic neuroendocrine tumors: from recurrence risk identification to therapeutic decision-making].

Abstract

The incidence of pancreatic neuroendocrine tumor (pNET) is increasingly year by year. While curative resection is the primary treatment, with observation and follow-up generally adopted postoperatively, the risk of recurrence after surgery is high. The role of adjuvant therapy for patients with pNET after surgery remains controversial, with international guidelines favoring a risk-stratified approach and Chinese guidelines recommending adjuvant therapy for high-risk patients (with lymph node metastasis or high-grade tumors). Combining domestic and international guidelines as well as research evidence, this article systematically elaborates on the current status and advances of postoperative adjuvant therapy in patients with pNET, ranging from identification of risk factors for postoperative recurrence (clinical and pathological factors, biochemical markers, imaging factors, and predictive models) to therapeutic decision-making [somatostatin analogs (SSA), targeted therapy, chemotherapy, peptide receptor radionuclide therapy (PRRT)], so as to provide reference for clinical decision-making.