Management of asymptomatic sporadic non-functioning pancreatic neuroendocrine neoplasms no larger than 2 cm: interim analysis of prospective ASPEN trial

The incidence of non-functioning pancreatic neuroendocrine neoplasms (NF-PanNENs) has increased recently. Traditionally, surgery has been the treatment of choice for localized NF-PanNENs, although evidence has emerged that active surveillance could be advocated for most asymptomatic tumours no larger than 2 cm. However, the practice of active surveillance varies considerably and, contrary to current recommendations, many patients still undergo surgical resection. Current evidence is limited by the retrospective design of studies and the small number of patients. The present study is the most extensive prospective investigation to date on small, asymptomatic NF-PanNENs. The aim was to define the optimal management of incidentally found, sporadic NF-PanNENs no larger than 2 cm.