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Meta-Analysis
. 2021 May 7;100(18):e25756.
doi: 10.1097/MD.0000000000025756.

Uracil-tegafur vs fluorouracil as postoperative adjuvant chemotherapy in Stage II and III colon cancer: A nationwide cohort study and meta-analysis

Po-Huang Chen  1   2 , Yi-Ying Wu  3 , Cho-Hao Lee  3 , Chi-Hsiang Chung  4   5   6 , Yu-Guang Chen  3   7 , Tzu-Chuan Huang  3 , Ren-Hua Yeh  3 , Ping-Ying Chang  3 , Ming-Shen Dai  3 , Shiue-Wei Lai  3 , Ching-Liang Ho  3 , Jia-Hong Chen  3 , Yeu-Chin Chen  3 , Je-Ming Hu  8 , Sung-Sen Yang  5   9   10 , Wu-Chien Chien  4   5   11
Affiliations
Meta-Analysis

Uracil-tegafur vs fluorouracil as postoperative adjuvant chemotherapy in Stage II and III colon cancer: A nationwide cohort study and meta-analysis

Po-Huang Chen et al. Medicine (Baltimore). .

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.

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Conflict of interest statement

The authors have no conflicts of interests to disclose.

Figures

Figure 1
Figure 1
Flowchart of the study sample selection from the NHIRD in Taiwan. NHIRD = National Health Insurance Research Database.
Figure 2
Figure 2
Kaplan–Meier for cumulative risk of disease-free survival (DFS, 2A) and overall survival (OS, 2B) among patients with Stage II and III colon cancer (NHIRD analysis).
Figure 3
Figure 3
Meta-analysis of the efficacy for UFT vs 5-FU as postoperative adjuvant chemotherapy in stage II and III colon cancer: disease-free survival (DFS, 3A) and overall survival (OS, 3B). Outcome analyses were performed using hazard ratio (HR) with related 95% confidence intervals. CI = confidence interval, DFS = disease-free survival, HR = hazard ratio, OS = overall survival.
See this image and copyright information in PMC

References

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