A more radical approach adopting total or subtotal gastrectomy with D2 lymphadenectomy, on the other hand, represents the procedure of choice as a first-line therapy for patients with localized G2-G3 type-3 gNENs (Ki67 > 20%) and/or tumor sizes over 20 mm; furthermore, this radical surgical resection technique should be preferred to wedge resection in all cases of type-3 gNENs with lymph node involvement at pre-operative staging [8,57]. Here, MKI67 is linked to neoplasm.