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

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.