Uracil-tegafur vs fluorouracil as postoperative adjuvant chemotherapy in Stage II and III colon cancer

Abstract

We conducted a population-based cohort study enrolling patients with Stage II and III colon cancer receiving postoperative adjuvant chemotherapy with uracil and tegafur (UFT) or fluorouracil (5-FU) from the Taiwan National Health Insurance Research Database from 2000 to 2015. The outcomes of the current study were disease-free survival (DFS) and overall survival (OS). Hazard ratios (HRs) were calculated by multivariate Cox proportional hazard regression models. We compared our effectiveness results from the literature by meta-analysis, which provided the best evidence. Severe adverse events were compared in meta-analysis of reported clinical trials. In the nationwide cohort study, UFT (14,486 patients) showed DFS similar to postoperative adjuvant chemotherapy (adjusted HR 1.037; 95% confidence interval [CI] 0.954–1.126; P = .397) and OS (adjusted HR 0.964; 95% CI 0.891–1.041; P = .349) compared with the 5-FU (866 patients). Our meta-analysis confirmed the similarity of effectiveness and found the incidence of leucopaenia was statistically significantly reduced in UFT (risk ratio 0.12; 95% CI 0.02–0.67; I 2 = 0%). Through our analysis, we have confirmed that UFT is a well-tolerated adjuvant therapy choice, and has similar treatment efficacy as 5-FU in terms of DFS and OS in patients with Stage II and III colon cancer.

Benefit of Uracil–Tegafur Used as a Postoperative Adjuvant Chemotherapy for Stage IIA Colon Cancer

“…Because of UFT’s tolerability and safety in an outpatient setting, it is the most commonly prescribed adjuvant chemotherapeutic for colon cancer in Taiwan [ 7 ]. A nationwide cohort study and meta-analysis demonstrated the similar effects of UFT and intravenous 5-FU on DFS and overall survival (OS), but UFT has a lower incidence of adverse events when used as a postoperative adjuvant chemotherapy in patients with locally advanced colon cancer [ 8 ].…”