Using oral tegafur/uracil (UFT) plus leucovorin as adjuvant chemotherapy in stage II colorectal cancer: a propensity score matching study from Taiwan

Yen-Lin Yu; Wen-Ko Tseng; Chun-Kai Liao; Chien-Yuh Yeh; Hong-Hwa Chen; Yu-Hsuan Liu; Yu-Wei Liaw; Chung-Wei Fan

doi:10.1186/s12885-023-11310-6

Using oral tegafur/uracil (UFT) plus leucovorin as adjuvant chemotherapy in stage II colorectal cancer: a propensity score matching study from Taiwan

BMC Cancer. 2023 Sep 25;23(1):900. doi: 10.1186/s12885-023-11310-6.

Authors

Yen-Lin Yu¹, Wen-Ko Tseng¹, Chun-Kai Liao², Chien-Yuh Yeh², Hong-Hwa Chen³, Yu-Hsuan Liu¹, Yu-Wei Liaw¹, Chung-Wei Fan⁴

Affiliations

¹ Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung Branch, No. 222 Maijin Rd., Anle Dist., Keelung City, 20401, Taiwan.
² Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
³ Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung Branch, No. 123, Dapi Rd., Niaosong Dist., Kaohsing City, 83301, Taiwan.
⁴ Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung Branch, No. 222 Maijin Rd., Anle Dist., Keelung City, 20401, Taiwan. cwf2564@adm.cgmh.org.tw.

Abstract

Background: Early-stage colorectal cancer had excellent outcomes after curative resection, typically. However, a perplexing survival paradox between stage II and stage III was noted. This paradox could be influenced by the administration of routine postoperative adjuvant chemotherapy and the presence of high-risk factors in stage II CRC. The objective of the study was to investigate the influence of high-risk factors on patients with stage II CRC and assess the efficacy of oral tegafur/uracil (UFT) plus leucovorin as adjuvant chemotherapy for stage II CRC patients.

Methods: A retrospective study was conducted using propensity score matching at a single medical institution. A total of 1544 patients with stage II colorectal cancer who underwent radical surgery between January 2004 and January 2009 were included. The intervention used was tegafur/uracil plus leucovorin as adjuvant chemotherapy. The main outcome measures were disease-free survival and overall survival.

Results: After propensity score matching, 261 patients were included in three groups: no-treatment, half-year treatment, and one-year treatment. The clinical characteristics of each group tended to be more consistent. The Cox proportional hazard models showed that tegafur/uracil treatment or not was a significant independent factor for oncological outcome. Kaplan-Meier analysis also showed significantly better disease-free survival and overall survival. Further investigation revealed that tegafur/uracil duration was an independent factor for oncological outcome. While the survival curve did not reach statistical significance, the one-year UFT treatment group demonstrated the best treatment trend.

Conclusions: This study suggests that tegafur/uracil plus leucovorin is a feasible adjuvant chemotherapy regimen for patients with stage II colorectal cancer after curative surgical treatment. Prolonged tegafur/uracil plus leucovorin treatment for 12 months showed a trend towards better outcomes in patients with stage II colorectal cancer.

Keywords: Adjuvant chemotherapy; Stage II colorectal cancer; Tegafur/uracil (UFT).

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / adverse effects
Chemotherapy, Adjuvant
Colorectal Neoplasms* / surgery
Humans
Leucovorin
Propensity Score
Retrospective Studies
Taiwan
Tegafur*
Treatment Outcome
Uracil

Substances

Tegafur
Leucovorin
Uracil