Uracil-tegafur vs fluorouracil as postoperative adjuvant chemotherapy in Stage II and III colon cancer: A nationwide cohort study and meta-analysis. Issue 18 (7th May 2021)

• Record Type: Journal Article
• Authors: Chen, Po-Huang; Wu, Yi-Ying; Lee, Cho-Hao; Chung, Chi-Hsiang; Chen, Yu-Guang; Huang, Tzu-Chuan; Yeh, Ren-Hua; Chang, Ping-Ying; Dai, Ming-Shen; Lai, Shiue-Wei; Ho, Ching-Liang; Chen, Jia-Hong; Chen, Yeu-Chin; Hu, Je-Ming; Yang, Sung-Sen; Chien, Wu-Chien
• Other Names: Ding. Jianxun section editor.
• Is Part Of: Medicine. Volume 100:Issue 18(2021)
• Publication Date: 2021-05-07
• Subjects: adjuvant chemotherapy -- colon cancer -- fluorouracil -- tegafur-uracil; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000025756
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : 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. Abstract : Supplemental Digital Content is available in the text