Department of Surgery, National Taiwan University Biomedical Park Hospital, Hsinchu County, Taiwan.
Department of Surgery, National Taiwan University Hospital, No. 7 Chung-Shan South Rd, Zhongzheng District, Taipei, 10002, Taiwan.
World J Surg Oncol. 2021 Apr 17;19(1):124. doi: 10.1186/s12957-021-02233-2.
Adjuvant tegafur-gimeracil-oteracil (S-1) is commonly used for gastric cancer in Asia, and tegafur-uracil (UFT) is another oral fluoropyrimidine when S-1 is unavailable. The real-world data of adjuvant UFT has less been investigated.
Patients with pathological stage II-IIIB (except T1) gastric cancer receiving adjuvant UFT or S-1 monotherapy after D2 gastrectomy were included. Usage of UFT or S-1 was based on reimbursement policy of the Taiwanese healthcare system. The characteristics, chemotherapy completion rates, and 5-year recurrence-free survival (RFS) and overall survival (OS), were compared between these two groups.
From 2005 to 2016, 86 eligible patients were included. Most tumor characteristics were similar between the UFT group (n = 37; age 59.1 ± 13.9 years) and S-1 group (n = 49; age 56.3 ± 10.7 years), except there were significantly more Borrmann type III/IV (86.5% versus 67.3%; p = 0.047) and T4 (56.8% versus 10.2%; p < 0.001) lesions in the UFT group than in the S-1 group. The chemotherapy complete rates were similar in the two groups. The 5-year RFS was 56.1% in the UFT group and 59.6% in the S-1 group (p = 0.71), and the 5-year OS was 78.3% in the UFT group and 73.1% in the S-1 group (p = 0.48). The hazard ratio of adjuvant chemotherapy (S-1 versus UFT) on RFS was 1.25 (95% confidence interval = 0.53-2.94) when Borrmann type and T and N stages were adjusted.
This small cohort study showed adjuvant UFT, and S-1 monotherapy had a comparable long-term outcome for pathological stage II-IIIB gastric cancer following D2 gastrectomy.
替加氟-吉美嘧啶-奥替拉西（S-1）在亚洲常用于治疗胃癌，而当 S-1 不可用时，替加氟-尿嘧啶（UFT）是另一种口服氟嘧啶。替加氟-UFT 的真实世界数据研究较少。
本研究纳入了接受 D2 胃切除术且接受替加氟-UFT 或 S-1 单药辅助治疗的病理分期为 II-IIIB 期（T1 除外）胃癌患者。UFT 或 S-1 的使用基于台湾医疗保健系统的报销政策。比较了两组患者的特征、化疗完成率以及 5 年无复发生存率（RFS）和总生存率（OS）。
2005 年至 2016 年，共纳入 86 例符合条件的患者。UFT 组（n=37；年龄 59.1±13.9 岁）和 S-1 组（n=49；年龄 56.3±10.7 岁）的大多数肿瘤特征相似，但 UFT 组的 Borrmann 型 III/IV （86.5%比 67.3%；p=0.047）和 T4（56.8%比 10.2%；p<0.001）病变更为常见。两组的化疗完全缓解率相似。UFT 组的 5 年 RFS 为 56.1%，S-1 组为 59.6%（p=0.71），UFT 组的 5 年 OS 为 78.3%，S-1 组为 73.1%（p=0.48）。调整 Borrmann 型和 T、N 分期后，辅助化疗（S-1 与 UFT）对 RFS 的风险比为 1.25（95%置信区间：0.53-2.94）。
本小队列研究表明，对于接受 D2 胃切除术的病理分期为 II-IIIB 期的胃癌患者，替加氟-UFT 和 S-1 单药辅助治疗的长期疗效相当。
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