With increasing median survival and wider use of diagnostic radiology methods there is an increase in findings of neuroendocrine pancreatic tumors (pNET) in old people. Surgery, even in this case, plays an important curative role.

Clinical records of patients over 75 years-old, who were diagnosed with a pNET (from 1979 to 2021) were retrieved retrospectively. We evaluated the reasons for excluding patients from surgery, and the postoperative outcome in those who underwent surgery.

Forty-two patients enrolled (20 men/22 women, averaging 80 years) among 397 patients observed. 36 patients had Non-Functioning pNET (85.7%). Tumor pancreatic location: 19 head, 23 body-tail. All patients with a F-pNET and 14 out of 36 with a NF-pNET underwent surgery, thus 20 out of 42 patients underwent surgery (47.6%). Surgery: 6 enucleations, 5 pancreatoduodenectomies, 9 distal pancreatectomies. 63% of operated patients had a stage 1 or 2 pNET. Overall morbidity 15%, including one grade B pancreatic fistula, one delayed gastric emptying, one acute heart failure. Average hospital stay 10 days. After a mean follow-up of six years, 10 out of 20 patients died; among them, four died for disease progression (2 stage 3B, 2 stage 4). Reasons why 22 patients were not operated: pNET <2 cm (n = 9), refused surgery (n = 5, median age 83 years), major comorbidities (n = 8).

Elderly patients with p-NET must be carefully selected to undergo surgery. If a good selection is made, the postoperative morbidity is very low, and the results are excellent.