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Uracil-tegafur vs fluorouracil as postoperative adjuvant chemotherapy in Stage II and III colon cancer: A nationwide cohort study and meta-analysis
Authors:Po-Huang Chen  Yi-Ying Wu  Cho-Hao Lee  Chi-Hsiang Chung  Yu-Guang Chen  Tzu-Chuan Huang  Ren-Hua Yeh  Ping-Ying Chang  Ming-Shen Dai  Shiue-Wei Lai  Ching-Liang Ho  Jia-Hong Chen  Yeu-Chin Chen  Je-Ming Hu  Sung-Sen Yang  Wu-Chien Chien
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; I2 = 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.
Keywords:adjuvant chemotherapy   colon cancer   fluorouracil   tegafur-uracil
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