In a cohort of 108 VHL patients with pNETs reported by Bransfield et al., the tumor doubling time was discovered to be shorter in patients with metastases (median 337 days; range 180–463 days) than in patients without metastases (median 2630 days; range 103–9614 days, P 0.0001) (18). This evidence concerns the gene VHL and neoplasm.