Consensus on the Clinical Diagnosis and Treatment of Grade 3 Pancreatic Neuroendocrine Tumors

The World Health Organization (WHO) 2017 classifications for neuroendocrine neoplasms (NENs) subdivided grade 3 pancreatic neoplasms (pNENs) into G3 well-differentiated pancreatic neuroendocrine tumors (G3 pNETs) and poorly-differentiated pancreatic neuroendocrine carcinomas (pNECs), according to the mitotic count, Ki-67 index and cell differentiation. As a new category, G3 pNETs remains a challenging group of tumors to manage by lacking large randomized trials and consensus to support its clinical practice. Therefore, the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association gathered experts in this field to formulate this consensus for the diagnosis and treatment of G3 pNETs.