Postoperative tegafur–uracil for stage I lung adenocarcinoma: first real-world data with an exploratory subgroup analysis

• Published in: Surgery today (Tokyo, Japan) Japan), 2023, Vol.53 (1), p.135-144
• Main Authors: Miyata, Ryo, Hamaji, Masatsugu, Nakakura, Akiyoshi, Morita, Satoshi, Shimazu, Yumeta, Ishikawa, Masashi, Kayawake, Hidenao, Menju, Toshi, Sakaguchi, Yasuto, Sonobe, Makoto, Takahashi, Mamoru, Aoyama, Akihiro, Sumitomo, Ryota, Huang, Cheng-Long, Kono, Tomoya, Miyahara, Ryo, Matsumoto, Akira, Katakura, Hiromichi, Fukada, Takahisa, Sakai, Hiroaki, Kobayashi, Masashi, Okumura, Norihito, Date, Naoki, Fujinaga, Takuji, Miyamoto, Ei, Nakagawa, Tatsuo, Date, Hiroshi
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adenocarcinoma of Lung - pathology; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy, Adjuvant; Humans; Lung Neoplasms - pathology; Medicine; Medicine & Public Health; Neoplasm Staging; Original Article; Retrospective Studies; Surgery; Surgical Oncology; Tegafur; Uracil
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-022-02546-z

Purpose The effect of postoperative tegafur–uracil on overall survival (OS) after resection of stage I adenocarcinoma has been shown in clinical trials. The purpose of this study was to investigate whether findings from randomized trials of adjuvant tegafur–uracil are reproducible in a real-world setting. Methods A retrospective cohort study was performed using a multi-institutional database that included all patients who underwent complete resection of pathological stage I adenocarcinoma between 2014 and 2016. Survival outcomes for patients managed with and without tegafur–uracil were analyzed using the Kaplan–Meier method and a Cox proportional hazards model for the whole patient cohort and in a selected cohort based on eligibility criteria of a previous randomized trial. Propensity score matching was used to adjust for confounding effects. Results After propensity score matching, the hazard ratios for OS were 0.57 (95% confidence interval (CI) 0.29–1.14, P  = 0.11) in the whole cohort and 0.69 (95% CI 0.32–1.50, P  = 0.35) in the selected cohort. Conclusions The effects of tegafur–uracil in this retrospective study appear to be consistent with those found in randomized clinical trials. These effects may be maximized in patients aged from 45 to 75 years.