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目的:探讨转化治疗后手术切除和直接手术切除对转移性胰腺神经内分泌肿瘤（PanNET）的疗效。方法:回顾性收集2010年 1月至2021年5月在复旦大学附属肿瘤医院手术治疗的转移性PanNET患者的病理资料和预后信息，分析其临床病理因素和预后的关系。并采用倾向评分匹配分析接受转化治疗后手术与直接手术的预后差异。结果:共纳入转移性PanNET患者101例，其中男58例，女43例，年龄18~74岁，中位年龄51岁。其中88例术式为原发灶联合肝转移灶切除，12例为原发灶联合其他器官或肝外转移灶切除，1例为原发灶切除。多因素分析显示，R2切除（n HR=1.943，95%n CI：1.262~2.990，n P=0.003）及G3分级（n HR=1.876，95%n CI：1.001~3.516，n P=0.05）为转移性患者术后进展的独立危险因素。63例（62.4%）患者直接手术，38例（37.6%）接受术前转化治疗。转化治疗组比直接手术组有更高比例的T3/T4期（68.1% 比39.7%，n P=0.007）、联合器官与肝外转移切除术式（26.3% 比9.5%，n P=0.005）及R2切除（71.1% 比42.9%，n P=0.005）。转化治疗组和直接手术组的中位无进展生存期（mPFS）差异无统计学意义（n P>0.005），但倾向评分重新匹配后，转化治疗组的mPFS优于直接手术组（n HR=0.442，95%n CI：0.207~0.943，n P=0.027）。n 结论:转移性PanNET行转化治疗再手术切除患者预后优于直接手术，切缘和分级是影响转移性PanNET预后的独立危险因素。“,”Objective:To explore the prognosis of Chinese patients with metastatic pancreatic neuroendocrine tumor (PanNET) treated with conversion therapy and surgical resection.Methods:The pathological data and prognostic information was retrospectively collected of patients with metastatic PanNET treated in Fudan University Shanghai cancer center from January 2010 to May 2021, and propensity score matching was used to analyze the prognosis difference between conversion treatment followed surgery and direct surgery.Results:There were 58 males and 43 females in 101 patients with metastatic PanNET. The age raged from 18 to 74 years, with a median age of 51 years. A total of 88 patients received primary tumor with liver metastases resection, 1 receied of primary tumor resection and 12 received primary tumor resection and combined organs or extrahepatic metastases. Multivariate analysis showed that R2(n HR=1.943,95%n CI:1.262-2.990,n P=0.003)resection and G3(n HR=1.876,95%n CI:1.001-3.516,n P=0.05) were independent risk factors for postoperative progression of metastatic patients. There were 63 patients (62.4%) who had received direct surgery, and 38 patients (37.6%) who had received preoperative conversion therapy. The conversion therapy had a higher proportion of T3/T4 stage (68.1% vs 39.7%, n P=0.007), resection with combined organs/extrahepatic metastasis (26.3% vs 9.5%, n P=0.005) and R2 resection (71.1% vs 42.9%, n P=0.005). The median progression-free survival (mPFS) between conversion therapy and direct surgery had no statistically significant, but after the propensity score matching the mPFS of the conversion therapy group was significantly longer than direct surgery group (n HR=0.442,95%n CI:0.207-0.943,n P=0.027).n Conclusions:Conversion therapy for partially metastatic PanNET is better than that of direct surgery. Radical resection and grade are independent prognostic factors for metastatic PanNET after resection.