Physical Activity Is Associated with Improved Overall Survival among Patients with Metastatic Colorectal Cancer

Publication date

2022-02-16

Authors

Smit, Karel C
Derksen, Jeroen W GORCID 0000-0002-2973-5583
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

Editors

Advisors

Supervisors

Document Type

Article

Collections

Open Access logo

License

cc_by

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 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.

Keywords

all-cause mortality, metastatic colorectal cancer, physical activity, survival, All-cause mortality, Physical activity, Survival, Metastatic colorectal cancer, Oncology, Cancer Research, Journal Article

Citation

Smit, K C, Derksen, J W G, Beets, G L O, Belt, E J T, Berbée, M, Coene, P P L O, van Cruijsen, H, Davidis, M A, Dekker, J W T, van Dodewaard-de Jong, J M, Haringhuizen, A W, Helgason, H H, Hendriks, M P, Hoekstra, R, de Hingh, I H J T, IJzermans, J N M, Janssen, J J B, Konsten, J L M, Los, M, Mekenkamp, L J M, Nieboer, P, Peeters, K C M J, Peters, N A J B, Pruijt, H J F M, Quarles van Ufford-Mannesse, P, Rietbroek, R C, Schiphorst, A H W, Schouten van der Velden, A, Schrauwen, R W M, Sie, M P S, Sommeijer, D W, Sonneveld, D J A, Stockmann, H B A C, Tent, M, Terheggen, F, Tjin-A-Ton, M L R, Valkenburg-van Iersel, L, van der Velden, A M T, Vles, W J, van Voorthuizen, T, Wegdam, J A, de Wilt, J H W, Koopman, M, May, A M & On Behalf Of The Plcrc Study Group 2022, 'Physical Activity Is Associated with Improved Overall Survival among Patients with Metastatic Colorectal Cancer', Cancers, vol. 14, no. 4, 1001. https://doi.org/10.3390/cancers14041001