Physical activity may improve disease-free survival following resection of stage III colon cancer

1. In this cohort study, physical activity was associated with improved disease-free survival in postoperative stage III colon cancer patients in the first year following surgical resection.

2. Furthermore, there was an overall survival benefit associated with physical activity that persisted in the first three years following surgical resection.

Evidence Rating Level: 2 (Good)

The literature has demonstrated that there is a benefit of doing physical activity after surgical resection of stage III colon cancer. However, prior studies have focused primarily on absolute rates of disease recurrence and death, rather than the risk at a specific time. As a result, the objective of the present study was to better characterize how exercise affects the time course of cancer recurrence in postoperative patients with stage III colon cancer.

The present prospective nested cohort study included 1696 patients with surgically resected stage III colon cancer from the National Cancer Trials Network in the USA and Canada from 2010-2015. Participants were enrolled between 21 and 56 days following surgical resection of stage III colonic adenocarcinoma and had an Eastern Cooperative Oncology Group (ECOG) performance status of ≤2. Participants were excluded if they had disease recurrence or died within 60 days of the first assessment. Physical activity was measured using a validated questionnaire at 4 and 14 months after surgical resection. The Müller and Wang plot method was used for statistical analysis. The primary outcome was disease-free survival.

The results demonstrated that physical activity was associated with improved disease-free survival in the first postoperative year. Furthermore, at no point during the surveillance period did the risk of recurrence of physically active patients exceed that of physically inactive patients. There was also a survival benefit associated with physical activity that persisted in the first three years following surgical resection. Despite these results, the study was limited by the cohort not being randomized, which may have led to confounding. Nonetheless, the present study added evidence to support physical activity in colon cancer survivors.

Click to read the study in British Journal of Sports Medicine

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