{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:56:17Z","timestamp":1790823377937,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Renal cell carcinoma (RCC) is the most common primary site of pancreatic metastases, and complete resection confers a favorable prognosis. Lenvatinib plus pembrolizumab (LEN\u2009+\u2009PEM) is standard first\u2010line therapy for advanced RCC; however, induction therapy before resection of pancreatic metastasis has not been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 77\u2010year\u2010old man presented with weight loss, anemia, and elevated inflammatory markers 30\u2009years after radical nephrectomy for RCC. Contrast\u2010enhanced computed tomography revealed a 42\u2010mm pancreatic head mass compressing the inferior vena cava, considered resectable, but high risk. Endoscopic ultrasound\u2010guided fine\u2010needle aspiration confirmed metastatic clear cell RCC. After LEN\u2009+\u2009PEM induction, the tumor decreased to 29\u2009mm, vena cava compression resolved, and subtotal stomach\u2010preserving pancreaticoduodenectomy achieved R0 resection. The patient remained recurrence\u2010free at 5\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LEN\u2009+\u2009PEM induction enabled R0 resection of pancreatic RCC metastasis, a site for which this strategy has not previously been reported.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iju5.70277","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:55:45Z","timestamp":1790819745000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Curative\u2010Intent Pancreatectomy for Pancreatic Metastasis From Renal Cell Carcinoma 30\u2009Years After Nephrectomy Following Lenvatinib Plus Pembrolizumab Therapy: A Case Report"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0425-2531","authenticated-orcid":false,"given":"Yuta","family":"Kaneko","sequence":"first","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reo","family":"Kotorii","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaishi","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuma","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9193-9133","authenticated-orcid":false,"given":"Seiya","family":"Hattori","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuto","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2021-2583","authenticated-orcid":false,"given":"Toru","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Momma","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Tokyo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.ejso.2013.12.022","article-title":"Pancreatectomy for Metastatic Disease: A Systematic Review","volume":"40","author":"Adler H.","year":"2014","journal-title":"European Journal of Surgical Oncology"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1016\/j.hpb.2025.07.003","article-title":"Surgery for Metastasis to the Pancreas: Systematic Review of Observational Cohort Studies","volume":"27","author":"Roals\u00f8 M. T.","year":"2025","journal-title":"HPB: The Official Journal of the International Hepato Pancreato Biliary Association"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2024.1442256","article-title":"A Pooled Analysis of Pancreatic Resection for Metastatic Renal Cell Carcinoma","volume":"14","author":"Zhou Y.","year":"2024","journal-title":"Frontiers in Oncology"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/bjs.6606","article-title":"Systematic Review of Pancreatic Surgery for Metastatic Renal Cell Carcinoma","volume":"96","author":"Tanis P. J.","year":"2009","journal-title":"British Journal of Surgery"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1056\/NEJMoa2035716","article-title":"Lenvatinib Plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma","volume":"384","author":"Motzer R.","year":"2021","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.6004\/jnccn.2021.0017","article-title":"Pancreatic Adenocarcinoma, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology","volume":"19","author":"Tempero M. A.","year":"2021","journal-title":"Journal of the National Comprehensive Cancer Network"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.pan.2017.11.011","article-title":"International Consensus on Definition and Criteria of Borderline Resectable Pancreatic Ductal Adenocarcinoma 2017","volume":"18","author":"Isaji S.","year":"2018","journal-title":"Pancreatology"},{"key":"e_1_2_10_9_1","first-page":"337","article-title":"Metastatic Tumors to the Pancreas: A Systematic Review and Meta\u2010Analysis","volume":"71","author":"Sperti C.","year":"2016","journal-title":"Minerva Chirurgica"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1245\/s10434-019-07258-2","article-title":"Surgical Resection for Metastatic Tumors in the Pancreas: A Single\u2010Center Experience and Systematic Review","volume":"26","author":"Huang Q.","year":"2019","journal-title":"Annals of Surgical Oncology"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/S1470-2045(23)00049-9","article-title":"Lenvatinib Plus Pembrolizumab Versus Sunitinib as First\u2010Line Treatment of Patients With Advanced Renal Cell Carcinoma (CLEAR): Extended Follow\u2010Up From the Phase 3, Randomised, Open\u2010Label Study","volume":"24","author":"Choueiri T. K.","year":"2023","journal-title":"Lancet Oncology"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"6902","DOI":"10.1002\/cam4.5483","article-title":"Lenvatinib Plus Pembrolizumab Versus Sunitinib for Advanced Renal Cell Carcinoma: Japanese Patients From the CLEAR Study","volume":"12","author":"Eto M.","year":"2023","journal-title":"Cancer Medicine"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1002\/ijc.35288","article-title":"Clinical Outcomes by Baseline Metastases in Patients With Renal Cell Carcinoma Treated With Lenvatinib Plus Pembrolizumab Versus Sunitinib: Post Hoc Analysis of the CLEAR Trial","volume":"156","author":"Gr\u00fcnwald V.","year":"2025","journal-title":"International Journal of Cancer"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2023.1132466","article-title":"The Impact of Cytoreductive Nephrectomy on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Receiving Immunotherapy: An Evidence\u2010Based Analysis of Comparative Outcomes","volume":"14","author":"Li K. P.","year":"2023","journal-title":"Frontiers in Immunology"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/MOU.0000000000000868","article-title":"Perioperative Therapy in Renal Cancer in the Era of Immune Checkpoint Inhibitor Therapy","volume":"31","author":"Kuusk T.","year":"2021","journal-title":"Current Opinion in Urology"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.clgc.2024.102177","article-title":"Pathological Response and Outcomes in Patients With Metastatic Renal Cell Carcinoma (mRCC) Receiving Immunotherapy\u2010Based Therapies and Undergoing Deferred Cytoreductive Nephrectomy (CN)","volume":"22","author":"Gunenc D.","year":"2024","journal-title":"Clinical Genitourinary Cancer"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1159\/000534000","article-title":"Downstaging and Pathological Complete Response of Locally Recurrent Sarcomatoid Renal Cell Carcinoma Under Pembrolizumab and Lenvatinib: A Case Report and Review of Literature","volume":"16","author":"Ell J.","year":"2023","journal-title":"Case Reports in Oncology"},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s13691-021-00501-2","article-title":"Pathological Eradication of Recurrent Metastatic Renal Cell Carcinoma With Sarcomatoid Component by Nivolumab Plus Ipilimumab Combination Therapy","volume":"10","author":"Sejima T.","year":"2021","journal-title":"International Cancer Conference Journal"},{"key":"e_1_2_10_19_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2025.1543060","article-title":"Case Report: Locally Invasive Thyroid Metastases From Renal Cell Carcinoma: Surgery After Neoadjuvant Therapy","volume":"15","author":"Hartl D. M.","year":"2025","journal-title":"Frontiers in Oncology"}],"container-title":["IJU Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/iju5.70277","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/iju5.70277","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/iju5.70277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:55:53Z","timestamp":1790819753000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/iju5.70277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/iju5.70277"],"URL":"https:\/\/doi.org\/10.1002\/iju5.70277","archive":["Portico"],"relation":{},"ISSN":["2577-171X","2577-171X"],"issn-type":[{"value":"2577-171X","type":"print"},{"value":"2577-171X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2026-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70277"}}