Abstract: Pancreatic neuroendocrine tumor is a common pancreatic tumor with high heterogeneity and multiple management modalities. A standard and practical staging system for pancreatic neuroendocrine tumors will be beneficial to clinical management and research. At present, there are two staging systems (ENETS and AJCC). Both of them have shortcomings which limit their clinical application. In addition, the coexistence of two staging systems is confusing to clinicians. We proposed a modified ENETS staging system by keeping the ENETS TNM definition and adopting the AJCC staging definition. The modified staging system can successfully distinguish patients with different prognosis and is helpful in establishing clinical standard. This study has been published in Journal of Clinical Oncology (JCO) and was selected as “2017 Best of JCO: Gastrointestinal edition”. This paper was aimed to interpret the modified staging system in clinical practice.

Key words: Pancreatic neuroendocrine tumor, Staging, Prognosis, European Neuroendocrine Tumor Society System, American Joint Committee on Cancer