Physical Activity Is Associated with Improved Overall Survival among Patients with Metastatic Colorectal Cancer
Smit, Karel C; Derksen, Jeroen W G; Beets, Geerard L O; Belt, Eric J Th; Berbée, Maaike; Coene, Peter Paul L O; van Cruijsen, Hester; Davidis, Marjan A; Dekker, Jan Willem T; van Dodewaard-de Jong, Joyce M; Haringhuizen, Annebeth W; Helgason, Helgi H; Hendriks, Mathijs P; Hoekstra, Ronald; de Hingh, Ignace H J T; IJzermans, Jan N M; Janssen, Johan J B; Konsten, Joop L M; Los, Maartje; Mekenkamp, Leonie J M; Nieboer, Peter; Peeters, Koen C M J; Peters, Natascha A J B; Pruijt, Hans J F M; Quarles van Ufford-Mannesse, Patricia; Rietbroek, Ron C; Schiphorst, Anandi H W; Schouten van der Velden, Arjan; Schrauwen, Ruud W M; Sie, Mark P S; Sommeijer, Dirkje W; Sonneveld, Dirk J A; Stockmann, Hein B A C; Tent, Marleen; Terheggen, Frederiek; Tjin-A-Ton, Manuel L R; Valkenburg-van Iersel, Liselot; van der Velden, Ankie M T; Vles, Wouter J; van Voorthuizen, Theo; Wegdam, Johannes A; de Wilt, Johannes H W; Koopman, Miriam; May, Anne M; On Behalf Of The Plcrc Study Group
(2022) Cancers, volume 14, issue 4
(Article)
Abstract
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
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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.
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Keywords: all-cause mortality, metastatic colorectal cancer, physical activity, survival, All-cause mortality, Physical activity, Survival, Metastatic colorectal cancer, Oncology, Cancer Research, Journal Article
ISSN: 2072-6694
Publisher: Multidisciplinary Digital Publishing Institute (MDPI)
Note: Funding Information: This research was supported by Regio Deal Foodvalley (grant nr 162135). The Prospective Dutch Colorectal Cancer (PLCRC) cohort is an initiative of the Dutch Colorectal Cancer Group (DCCG). PLCRC is supported by the Dutch Cancer Society; Stand Up to Cancer; ZonMw; Health Holland; Maag Lever Darm Stichting; Lilly (unrestricted grant); Merck (unrestricted grant); Bristol-Myers Squibb (unrestricted grant); Bayer (unrestricted grant); and Servier (unrestricted grant). Funding Information: Funding: This research was supported by Regio Deal Foodvalley (grant nr 162135). The Prospective Dutch Colorectal Cancer (PLCRC) cohort is an initiative of the Dutch Colorectal Cancer Group (DCCG). PLCRC is supported by the Dutch Cancer Society; Stand Up to Cancer; ZonMw; Health Holland; Maag Lever Darm Stichting; Lilly (unrestricted grant); Merck (unrestricted grant); Bristol-Myers Squibb (unrestricted grant); Bayer (unrestricted grant); and Servier (unrestricted grant). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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