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

We determined if postoperative physical activity prevents or delays cancer recurrence in patients with stage III colon cancer. 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. 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). 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.

Informations de copyright

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: JCB reported receiving grants from the National Institutes of Health and the American Institute for Cancer Research. QS reports consulting/advisory role from Yiviva, Boehringer Ingelheim Pharmaceuticals, Regeneron Pharmaceuticals, Hoosier Cancer Research Network and Kronos Bio; honorarium/speaker role from Chugai Pharmaceutical Co., Ltd (to QA), research funds from Celgene/BMS, Roche/Genentech, Janssen, Novartis (to institution). PK reported receiving grants from the Columbus National Community Oncology Research Program and the National Institutes of Cancer. AFS reported receiving grants from the National Cancer Institute. No other disclosures were reported. JAM reported receiving personal fees for serving on the advisory boards of COTA Healthcare and Merck Pharmaceutical. All other authors disclosed no conflicts of interest.