I agree with the comments above. Get a NET specialist ASAP. The facts cited by others like grade etc matter. I will add that your insurance matters too and the course of action may be influenced by the insurance company, Hence important to have a NET oncologist that can help navigate this. I did have surgery to remove SINET, GB, cancer lymph nodes 5 months after diagnosis but only after a blockage, ie emergency as this is not what the insurance will approve at first. Since you are Stage IV you may get similar resistance from insurance.