Skip to main content
SpringerLink
Log in

Long-Term Survival Results of Surgery Alone Versus Surgery plus UFT (Uracil and Tegafur)-Based Adjuvant Therapy in Patients with Stage II Colon Cancer

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, et al.: Cancer statistics, 2009. CA Cancer J Clin 2009;59:225-249.

    Article  PubMed  Google Scholar 

  2. Annual Cancer report from Taiwan Cancer Registration system; Department of Health, ROC. 2009.

  3. O’Connell JB, Maggard MA, Ko CY: Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst 2004;96:1420-1425.

    Article  PubMed  Google Scholar 

  4. NIH Consensus Conference: Adjuvant cancer therapy. JAMA 1990;264:1444-1450.

    Article  Google Scholar 

  5. Edge SB, Byrd DR, Compton CC, et al.: AJCC Cancer Staging Manual. 7th ed. Philadelphia: Springer; 2010. pp. 143-164.

    Google Scholar 

  6. Benson AB 3 rd, Schrag D, Somerfield MR, et al.: American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol 2004;22: 3408-3419.

    Article  PubMed  Google Scholar 

  7. Rousseau B, Chibaudel B, Bachet JB, et al.: Stage II and stage III colon cancer: treatment advances and future directions. Cancer J. 2010;16: 202-209

    Article  PubMed  CAS  Google Scholar 

  8. Tanaka F: UFT (tegafur and uracil) as postoperative adjuvant chemotherapy for solid tumors (carcinoma of the lung, stomach, colon/rectum, and breast): clinical evidence, mechanism of action, and future direction. Surg Today 2007;37:923-943.

    Article  PubMed  CAS  Google Scholar 

  9. Carmichael J, Popiela T, Radstone D, et al.: Randomized comparative study of tegafur/uracil and oral leucovorin versus parenteral fluorouracil and leucovorin in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2002;20:3617-3627.

    Article  PubMed  CAS  Google Scholar 

  10. Douillard JY, Hoff PM, Skillings JR, et al.: Multicenter phase III study of uracil/tegafur and oral leucovorin versus fluorouracil and leucovorin in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2002;20:3605-3616.

    Article  PubMed  CAS  Google Scholar 

  11. Lembersky BC, Wieand HS, Petrelli NJ, et al.: Oral uracil and tegafur plus leucovorin compared with intravenous fluorouracil and leucovorin in stage II and III carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project Protocol C-06. J Clin Oncol 2006;24:2059-2064.

    Article  PubMed  CAS  Google Scholar 

  12. Sakamoto J, Ohashi Y, Hamada C, et al.: Efficacy of oral adjuvant therapy after resection of colorectal cancer: 5-year results from three randomized trials. J Clin Oncol 2004;22:484-492.

    PubMed  Google Scholar 

  13. Gill S, Loprinzi CL, Sargent DJ, et al.: Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer: who benefits and by how much? J Clin Oncol 2004;22: 1797-1806.

    Article  PubMed  CAS  Google Scholar 

  14. André T, Boni C, Navarro M, et al.: Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009;27:3109–3116.

    Article  PubMed  Google Scholar 

  15. Wilkinson NW, Yothers G, Lopa S, et al.: Long-term survival results of surgery alone versus surgery plus 5-fluorouracil and leucovorin for stage II and stage III colon cancer: pooled analysis of NSABP C-01 through C-05. A baseline from which to compare modern adjuvant trials. Ann Surg Oncol. 2010;17: 959-66.

    Article  PubMed  Google Scholar 

  16. Sargent D, Sobrero A, Grothey A, et al.: Evidence for cure by adjuvant therapy in colon cancer: observations based on individual patient data from 20,898 patients on 18 randomized trials. J Clin Oncol. 2009;27: 872-877

    Article  PubMed  Google Scholar 

  17. Quasar Collaborative Group, Gray R, Barnwell J, et al.: Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet 2007;370: 2020-2029.

    Article  PubMed  Google Scholar 

  18. Swanson RS, Compton CC, Stewart AK, et al.: The prognosis of T3N0 colon cancer is dependent on the number of lymph nodes examined. Ann Surg Oncol 2003;10:65–71.

    Article  PubMed  Google Scholar 

  19. Prandi M, Lionetto R, Bini A, et al.: Prognostic evaluation of stage B colon cancer patients is improved by an adequate lymphadenectomy: results of a secondary analysis of a large scale adjuvant trial. Ann Surg 2002;235:458–463.

    Article  PubMed  Google Scholar 

  20. Le Voyer TE, Sigurdson ER, Hanlon AL, et al.: Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of Intergroup trial INT-0089. J Clin Oncol 2003;21:2912–2919.

    Article  PubMed  Google Scholar 

  21. Joseph NE, Sigurdson ER, Hanlon AL, et al.: Accuracy of determining nodal negativity in colorectal cancer on the basis of the number of nodes retrieved on resection. Ann Surg Oncol 2003;10:213–218.

    Article  PubMed  Google Scholar 

  22. Vather R, Sammour T, Kahokehr A, et al.: Lymph node evaluation and long-term survival in stage II and stage III colon cancer: a national study. Ann Surg Oncol 2009;16:585-593.

    Article  PubMed  Google Scholar 

  23. Chang GJ, Rodriguez-Bigas MA, Skibber JM, et al.: Lymph node evaluation and survival after curative resection of colon cancer: systematic review. J Natl Cancer Inst 2007;99:433-441.

    Article  PubMed  Google Scholar 

  24. Earle CC, Weiser MR, Ter Veer A, et al.: Effect of lymph node retrieval rates on the utilization of adjuvant chemotherapy in stage II colon cancer. J Surg Oncol 2009;100:525-528

    Article  PubMed  CAS  Google Scholar 

  25. Wong SL, Ji H, Hollenbeck BK, et al.: Hospital lymph node examination rates and survival after resection for colon cancer. JAMA 2007;298:2149-2154.

    Article  PubMed  CAS  Google Scholar 

  26. Bilimoria KY, Bentrem DJ, Stewart AK, et al.: Lymph node evaluation as a colon cancer quality measure: a national hospital report card. J Natl Cancer Inst 2008;100:1310-1317.

    Article  PubMed  Google Scholar 

Download references

Author disclosures

We certify that the authors of this article do not have commercial associations that might pose a conflict of interest in connection with the submitted article.

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Colorectal Surgery, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan, People’s Republic of China

    Been-Ren Lin, Hong-Shiee Lai, Po-Huang Lee, King-Jen Chang & Jin-Tung Liang

  2. Department of Surgery, Division of Colorectal Surgery, Taipei University Shuang-Ho Hospital, No. 291, Zhongzheng Rd., Zhonghe City, Taipei County 235, Taiwan, People’s Republic of China

    Tung-Cheng Chang

Authors
  1. Been-Ren Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hong-Shiee Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tung-Cheng Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Po-Huang Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. King-Jen Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jin-Tung Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jin-Tung Liang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lin, BR., Lai, HS., Chang, TC. et al. 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 15, 2239–2245 (2011). https://doi.org/10.1007/s11605-011-1722-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-011-1722-4

Keywords

Search

Navigation