Abstract |
Frequent recurrence of hepatocellular carcinoma (HCC) after surgery remains a major clinical problem. This randomized controlled trial evaluated whether postoperative adjuvant therapy with oral uracil- tegafur (UFT) prevents recurrence of HCC. A total of 160 patients who underwent curative hepatic resection for HCC were randomly assigned to receive either 300 mg/day of UFT for 1 year after surgery (n = 79, UFT group) or surgery alone (n = 80, control group). The primary endpoint was recurrence-free survival, and the secondary endpoint was overall survival. Other study variables included liver function and type of recurrence. During a median follow-up of 4.8 years (range: 0.5-7.9), recurrence-free survival curves in the groups were similar (P = .87). Overall survival was slightly but not significantly worse in the UFT group than in the control group (P = .08). The rates of recurrence-free and overall survival at 5 years were 29% and 58%, respectively, in the UFT group, as compared with 29% and 73%, respectively, in the control group. The hazard ratio for recurrence in the UFT group, relative to the control, was 1.01 (95% confidence interval: 0.84-1.22, P = .87). The proportion of patients with advanced recurrence (i.e., multiple, extrahepatic, or associated with vascular invasion) was significantly higher in the UFT group (74%, 43 of 58 patients with recurrence) than in the control group (53%, 30 of 57) (P = .02). In conclusion, our results offer no evidence to support potential benefits of adjuvant chemotherapy with UFT after surgery in patients with HCC and suggest that such treatment may even worsen overall survival.
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Authors | Kiyoshi Hasegawa, Tadatoshi Takayama, Masayoshi Ijichi, Yutaka Matsuyama, Hiroshi Imamura, Keiji Sano, Yasuhiko Sugawara, Norihiro Kokudo, Masatoshi Makuuchi |
Journal | Hepatology (Baltimore, Md.)
(Hepatology)
Vol. 44
Issue 4
Pg. 891-5
(Oct 2006)
ISSN: 0270-9139 [Print] United States |
PMID | 17006925
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Carcinoma, Hepatocellular
(drug therapy, surgery)
- Chemotherapy, Adjuvant
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Liver Neoplasms
(drug therapy, surgery)
- Male
- Middle Aged
- Neoplasm Recurrence, Local
(prevention & control)
- Survival Rate
- Tegafur
(administration & dosage)
- Uracil
(therapeutic use)
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