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Alvimopan may shorten hospital stays after surgery for testicular cancer
Alvimopan facilitated gastrointestinal recovery and shortened hospital stays among a small group of men with testicular cancer who underwent retroperitoneal lymph node dissection, according to a study presented at the Genitourinary Cancers Symposium.
“[Retroperitoneal lymph node dissection (RPLND)] is a technically challenging procedure that can be associated with perioperative morbidity and delay in recovery of gastrointestinal function,” Thomas L. Jang, MD, MPH, professor of surgery at Rutgers Robert Wood Johnson Medical School, said in a press release. “Strategies that enhance post-surgery recovery, such as the adoption of alvimopan [Entereg, Merck] in recovery pathways, may minimize gastrointestinal side effects and shorten the length of hospital stay for these men.”
RPLND is a procedure in which abdominal lymph nodes and masses that persist after chemotherapy are removed. The procedure can delay gastrointestinal recovery, which can result in longer hospital stays.
Previous studies have shown alvimopan — commonly used to reduce the side effects of pain medications given after surgery — significantly accelerated recovery of gastrointestinal function and shortened hospital stays for patients undergoing surgery for gastrointestinal or bladder cancer. Jang and colleagues explored the effect of alvimopan on men with testicular cancer who underwent RPLND procedures.
Twenty-nine patients underwent RPLND procedures — 23 of whom did so postchemotherapy — from 2010 to 2016, all of whom received bilateral template dissections. Eight patients received alvimopan, and 21 did not.
Length of hospital stay and recovery of GI function served as primary endpoints.
The researchers observed no differences in preoperative or operative variables between the groups.
Men who received alvimopan had a significantly shorter median hospital stay (4 days vs. 6 days; P = .0074), median time to return of flatus (2 days vs. 4 days; P = .0023) and median time to first bowel movement (2.5 days vs. 4 days; P = .0028).
“We aim to validate these findings through a randomized controlled clinical trial at Rutgers Cancer Institute in the near future,” Jang said. – by Chuck Gormley
Reference:
Radadia KD, et al. Abstract 424. Presented at: Genitourinary Cancers Symposium; Feb. 16-18, 2017; Orlando, Fla.
Disclosure: Jang and the other researchers report no relevant financial disclosures.