The incidence of pNET is increasing in China as well as the world in recent years. Surgery is one of the main measures in treating pNET. Generally, there is few disputes on the surgical resection of localized lesion and resectable metastatic disease. There are still some disputes on the treatment combination and sequence of unresectable metastatic disease. In Zhongshan Hospital, the 5-year survival after radical resection of localized disease was 93%, the main cause of treatment failure was liver metastasis, the median metastatic time was 38.7 months. In our retrospective study, we found that liver directed therapy (surgical resection, TACE, Radiofrequency, microwave ablation) were more effective compared with systemic treatment. Whether the primary lesion should be resected when there are unresectable metastatic lesions is another focus of the debate. Until now, there is no evidence-based result support routine resection of primary lesion, unless there are life-threaten complications like jaundice, digestive tract obstruction etc. Liver transplantation is last choice for the treatment of pNET with liver metastasis, but should be restricted to patients with G1 or G2 disease and there is no extrahepatic disease