Physical Activity Is Associated with Improved Overall Survival among Patients with Metastatic Colorectal Cancer.
Karel C SmitJeroen W G DerksenGeerard L O BeetsEric J Th BeltMaaike BerbéePeter Paul L O CoeneHester van CruijsenMarjan A DavidisJan Willem T DekkerJoyce M van Dodewaard-de JongAnnebeth W HaringhuizenHelgi H HelgasonMarieke H J van den Beuken-van EverdingenRonald HoekstraIgnace H J T de HinghJan Nicolaas Maria IJzermansJohan J B JanssenJoop L M KonstenMaartje LosLeonie J M MekenkampPeter NieboerKoen C M J PeetersNatascha A J B PetersHans J F M PruijtPatricia Quarles van Ufford-MannesseRon C RietbroekAnandi H W SchiphorstArjan Schouten van der VeldenRuud W M SchrauwenMark P S SieDirkje W SommeijerDirk J A SonneveldHein B A C StockmannMarleen TentFrederiek TerheggenManuel L R Tjin-A-TonLiselot Valkenburg-van IerselAnkie M T van der VeldenWouter J VlesTheo van VoorthuizenJohannes A WegdamJohannes H W de WiltMiriam KoopmanAnne M Maynull On Behalf Of The Plcrc Study GroupPublished in: Cancers (2022)
Regular physical activity (PA) is associated with improved overall survival (OS) in stage I-III colorectal cancer (CRC) patients. This association is less defined in patients with metastatic CRC (mCRC). We therefore conducted a study in mCRC patients participating in the Prospective Dutch Colorectal Cancer cohort. PA was assessed with the validated SQUASH questionnaire, filled-in within a maximum of 60 days after diagnosis of mCRC. PA was quantified by calculating Metabolic Equivalent Task (MET) hours per week. American College of Sports and Medicine (ACSM) PA guideline adherence, tertiles of moderate to vigorous PA (MVPA), and sport and leisure time MVPA (MVPA-SL) were assessed as well. Vital status was obtained from the municipal population registry. Cox proportional-hazards models were used to study the association between PA determinants and all-cause mortality adjusted for prognostic patient and treatment-related factors. In total, 293 mCRC patients (mean age 62.9 ± 10.6 years, 67% male) were included in the analysis. Compared to low levels, moderate and high levels of MET-hours were significantly associated with longer OS (fully adjusted hazard ratios: 0.491, (95% CI 0.299-0.807, p value = 0.005) and 0.485 (95% CI 0.303-0.778, p value = 0.003), respectively), as were high levels of MVPA (0.476 (95% CI 0.278-0.816, p value = 0.007)) and MVPA-SL (0.389 (95% CI 0.224-0.677, p value < 0.001)), and adherence to ACSM PA guidelines compared to non-adherence (0.629 (95% CI 0.412-0.961, p value = 0.032)). The present study provides evidence that higher PA levels at diagnosis of mCRC are associated with longer OS.
Keyphrases
- physical activity
- end stage renal disease
- ejection fraction
- chronic kidney disease
- newly diagnosed
- prognostic factors
- type diabetes
- randomized controlled trial
- risk assessment
- high intensity
- patient reported outcomes
- metastatic colorectal cancer
- patient reported
- case report
- cross sectional
- adipose tissue
- depressive symptoms
- data analysis
- sleep quality
- sewage sludge
- double blind