Lopez-Aguiar AG, et al. - Given the controversies regarding the management of <2-cm pancreatic neuroendocrine tumors, researchers analyzed all patients who underwent resection of primary nonfunctional <2-cm with curative-intent at 8 institutions of the US Neuroendocrine Tumor Study Group from 2000 to 2016, and created a lymph node risk score that predicted lymph node metastases accurately for <2-cm pancreatic neuroendocrine tumors, utilizing readily available preoperative data. Among 695 patients, 309 had resected pancreatic neuroendocrine tumors <2 cm. Proximal location and Ki-67 >3% were the factors known preoperatively to be associated with lymph node metastases. A lymph node risk score ranging 1–7 was formed via assigning location and Ki-67 a value weighted by their odds ratio (distal= 1, proximal= 4, and Ki-67 < 3% = 1 and Ki-67 > 3% = 3). This simple and novel lymph node risk score could stratify risk of lymph node metastases accurately for < 2-cm pancreatic neuroendocrine tumors and may assist in guide management strategy.