Background: The objective of this study was to assess the role of uracil/tegafur (UFT) and its metabolite γ-butyrolactone (GBL), a potent inhibitor of angiogenesis, in the prevention of intravesical recurrence in patients with non-muscle invasive urothelial carcinoma of the bladder (NMIUCB). Patients and Methods: This study included 48 patients with NMIUCB following complete transurethral resection who were randomly divided into 27 receiving UFT therapy (group A) and 21 without any adjuvant therapies (group B). Serum levels of GBL, vascular endothelial growth factor, basic fibroblast growth factor, platelet-derived growth factor and interleukin-8 were measured. Results: There was no significant difference in the intravesical recurrence-free survival between groups A and B. Despite the lack of significant differences in serum levels of vascular endothelial growth factor, basic fibroblast growth factor, platelet-derived growth factor and interleukin-8, serum GBL in group A was significantly greater than in group B. Multivariate analysis identified tumor size as an independent predictor of intravesical recurrence irrespective of the other factors examined. Conclusions: Despite the significant induction of GBL, adjuvant UFT therapy failed to show a preventive effect on intravesical recurrence of NMIUCB. Therefore, we should consider enhancing the anti-angiogenic effect of GBL using an alternative administration schedule of UFT.

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