Association between physical activity and the time course of cancer recurrence in stage III colon cancer

Justin C. Brown, Chao Ma, Qian Shi, Donna Niedzwiecki, Tyler Zemla, Felix Couture, Philip Kuebler, Pankaj Kumar, Judith O. Hopkins, Benjamin Tan, Smitha Krishnamurthi, Eileen M. O'Reilly, Anthony F. Shields, Jeffrey A. Meyerhardt

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7 Scopus citations

Abstract

Objective We determined if postoperative physical activity prevents or delays cancer recurrence in patients with stage III colon cancer. Methods This cohort study nested within a randomised trial enrolled 1696 patients with surgically resected stage III colon cancer. Physical activity was calculated based on self-reporting during and after chemotherapy. Patients were classified as physically active (≥9 MET-h/wk, comparable with the energy expenditure of 150 min/wk of brisk walking, consistent with the current physical activity guidelines for cancer survivors) or physically inactive (<9 MET-h/wk). The confounder-adjusted hazard rate (risk of recurrence or death) and HR by physical activity category were estimated with continuous time to allow non-proportionality of hazards. Results During a median 5.9 years follow-up, 457 patients experienced disease recurrence or death. For physically active and physically inactive patients, the risk of disease recurrence peaked between 1 and 2 years postoperatively and declined gradually to year 5. The risk of recurrence in physically active patients never exceeded that of physically inactive patients during follow-up, suggesting that physical activity prevents - as opposed to delays - cancer recurrence in some patients. A statistically significant disease-free survival benefit associated with physical activity was observed during the first postoperative year (HR 0.68, 95% CI 0.51 to 0.92). A statistically significant overall survival benefit associated with physical activity was observed during the first three postoperative years (HR 0.32, 95% CI 0.19 to 0.51). Conclusions In this observational study of patients with stage III colon cancer, postoperative physical activity is associated with improved disease-free survival by lowering the recurrence rate within the first year of treatment, which translates into an overall survival benefit.

Original languageEnglish
Pages (from-to)965-971
Number of pages7
JournalBritish journal of sports medicine
Volume57
Issue number15
DOIs
StatePublished - Aug 1 2023

Keywords

  • epidemiology
  • sports medicine

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