TY - JOUR
T1 - Inflammation, physical activity, and disease-free survival in stage III colon cancer
T2 - Cancer and Leukemia Group B–Southwest Oncology Group 80702 (Alliance)
AU - Brown, Justin C.
AU - Ma, Chao
AU - Shi, Qian
AU - Couture, Felix
AU - Kuebler, Philip
AU - Kumar, Pankaj
AU - Tan, Benjamin
AU - Krishnamurthi, Smitha
AU - Chang, Victor
AU - Goldberg, Richard M.
AU - O’Reilly, Eileen M.
AU - Shields, Anthony F.
AU - Meyerhardt, Jeffrey A.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12/1
Y1 - 2024/12/1
N2 - Background: Inflammation and insufficient physical inactivity contribute to individual-level risk of disease recurrence and death in stage III colon cancer. The extent to which increased inflammatory risk can be offset by sufficient physical activity remains unknown. Methods: This cohort study was nested within the Cancer and Leukemia Group B (now part of the Alliance for Clinical Trials in Oncology) and Southwest Oncology Group randomized trial. Inflammatory burden was quantified by high-sensitivity C-reactive protein, interleukin-6, and soluble tumor necrosis factor-α receptor 2 after recovery from tumor resection. Physical activity was measured during and after postoperative chemotherapy. The primary endpoint was disease-free survival. Results: The 3-year disease-free survival rate was 88.4% among patients with low inflammation and sufficient physical activity (referent group for all comparisons), 84.9% with low inflammation and insufficient physical activity (absolute risk difference ¼ −3.5 percentage points, 95% confidence interval [CI] ¼ −11.3 to 4.3; P¼ .38), 78.0% with intermediate inflammation and insufficient physical activity (absolute risk difference ¼ −10.4 percentage points, 95% CI ¼ −17.4 to −3.3; P¼ .007), and 79.7% with high inflammation and insufficient physical activity (absolute risk difference ¼ −8.7 percentage points, 95% CI ¼ −15.7 to −1.6; P¼ .022). In contrast, the 3-year disease-free survival rate was 87.3% among patients with intermediate inflammation and sufficient physical activity (absolute risk difference ¼ −1.1 percentage points, 95% CI ¼ −7.5 to 5.3; P¼ .74) and 84.4% with high inflammation and sufficient physical activity (absolute risk difference ¼ −4.0 percentage points, 95% CI ¼ −12.3 to 4.3; P¼ .34). Conclusion: In this observational study of stage III colon cancer patients, physical activity was associated with improved disease-free survival despite high inflammation. Patients with intermediate or high inflammation who were physically active had disease-free survival rates that were not statistically significantly different from those with low inflammation.
AB - Background: Inflammation and insufficient physical inactivity contribute to individual-level risk of disease recurrence and death in stage III colon cancer. The extent to which increased inflammatory risk can be offset by sufficient physical activity remains unknown. Methods: This cohort study was nested within the Cancer and Leukemia Group B (now part of the Alliance for Clinical Trials in Oncology) and Southwest Oncology Group randomized trial. Inflammatory burden was quantified by high-sensitivity C-reactive protein, interleukin-6, and soluble tumor necrosis factor-α receptor 2 after recovery from tumor resection. Physical activity was measured during and after postoperative chemotherapy. The primary endpoint was disease-free survival. Results: The 3-year disease-free survival rate was 88.4% among patients with low inflammation and sufficient physical activity (referent group for all comparisons), 84.9% with low inflammation and insufficient physical activity (absolute risk difference ¼ −3.5 percentage points, 95% confidence interval [CI] ¼ −11.3 to 4.3; P¼ .38), 78.0% with intermediate inflammation and insufficient physical activity (absolute risk difference ¼ −10.4 percentage points, 95% CI ¼ −17.4 to −3.3; P¼ .007), and 79.7% with high inflammation and insufficient physical activity (absolute risk difference ¼ −8.7 percentage points, 95% CI ¼ −15.7 to −1.6; P¼ .022). In contrast, the 3-year disease-free survival rate was 87.3% among patients with intermediate inflammation and sufficient physical activity (absolute risk difference ¼ −1.1 percentage points, 95% CI ¼ −7.5 to 5.3; P¼ .74) and 84.4% with high inflammation and sufficient physical activity (absolute risk difference ¼ −4.0 percentage points, 95% CI ¼ −12.3 to 4.3; P¼ .34). Conclusion: In this observational study of stage III colon cancer patients, physical activity was associated with improved disease-free survival despite high inflammation. Patients with intermediate or high inflammation who were physically active had disease-free survival rates that were not statistically significantly different from those with low inflammation.
UR - http://www.scopus.com/inward/record.url?scp=85212457470&partnerID=8YFLogxK
U2 - 10.1093/jnci/djae203
DO - 10.1093/jnci/djae203
M3 - Article
C2 - 39180477
AN - SCOPUS:85212457470
SN - 0027-8874
VL - 116
SP - 2032
EP - 2039
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 12
ER -