Long-term survival results of surgery alone versus surgery plus UFT (Uracil and Tegafur)-based adjuvant therapy in patients with stage II colon cancer

J Gastrointest Surg. 2011 Dec;15(12):2239-45. doi: 10.1007/s11605-011-1722-4. Epub 2011 Oct 13.

Abstract

Background: It is well established that adjuvant chemotherapy with 5-fluouracil and leucovorin (5-FU/LV) improves survival for patients with resected colon cancer; however, the benefits of oral uracil and tegafur (UFT) chemotherapy in these patients are still uncertain.

Methods: All patients enrolled in this retrospective study with stage II disease who were treated with surgery or surgery plus UFT were examined to determine the overall survival and disease-free interval. Time-to-event by treatment group was examined using Kaplan-Meier estimates and multivariable Cox regression analysis.

Results: There were 456 eligible patients-217 (47.5%) patients had surgery and 239 (52.5%) patients had surgery plus UFT. In patients aged ≧65 years, deeper tumor depth and fewer nodes observed were associated with lower survival. The 5-year survival rate was 84.2% in the surgery group and 89.1% in the surgery plus UFT group (P = 0.006). Treatment with UFT after surgery was associated with improved outcome compared with surgery alone: overall survival (HR = 0.611, P = 0.018) and disease-free survival (HR = 0.590, P = 0.032).

Conclusions: Oral fluoropyrimidines improve the disease-free rate and the overall survival of patients after resection of stage II colon cancer. These observations support the use of these agents following surgery as it provides a benefit over surgery alone.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / administration & dosage
  • Chemotherapy, Adjuvant
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Outcome Assessment, Health Care*
  • Retrospective Studies
  • Taiwan
  • Tegafur / administration & dosage
  • Treatment Outcome
  • Uracil / administration & dosage

Substances

  • Antimetabolites, Antineoplastic
  • Tegafur
  • Uracil