Six-Minutes' Walk Test and Handgrip Strength Associated with Increased Health-Related Quality of Life in Patients with Colorectal Cancer.

PURPOSE: The number of cancer survivors has been increasing in Europe by 3.5% per year since 2010. Overall, 38% of all prevalent cases will live more than 10 yr after the diagnosis. Colorectal cancer (CRC) stands as the second most prevalent cancer among survivors across genders. Interestingly, most CRC survivors will be older than 75 and will possibly need survivorship care services. This study's primary aim was to investigate the association between physical fitness and health-related quality of life (HRQoL) in patients with CRC. Secondary analyses explored detailed subdomains.

METHODS

We investigated the cross-sectional association between physical fitness, measured with the 6-min walk test (6MWT) and isometric handgrip strength, and HRQoL in a cohort of Portuguese and Spanish CRC patients ( N = 272, mean [standard deviation] age: 65 ± 10.8 yr, 65% men; and 11%, 22%, 36%, and 31% in stages I, II, III, and IV, respectively). Linear regression models were used to assess the association between physical fitness and HRQoL. Minimally important differences (MIDs) of 5-10 points were used to evaluate clinical relevance.

RESULTS

Mean (standard deviation) global HRQoL was 69.2 (21.8). A 50-m longer 6MWT distance was associated with differences in cognitive function ( β : 0.11 [0.08-0.14]) and body weight ( β : 0.10 [0.05-0.14]) scores that exceeded the MIDs threshold (5-10 points), suggesting potential clinical relevance. Additionally, physical function, role function, emotional function, dyspnea, and anxiety approached clinical relevance with differences ranging from +4.0 to +4.5 points. A 5-kg increase in handgrip strength was associated with meaningful differences in several HRQoL domains: role function ( β : 1.90 [1.45-2.36]), fatigue ( β : -1.64 [-2.11 to -1.18]), nausea/vomiting ( β : -1.96 [-2.42 to -1.51]), body image ( β : 1.14 [0.63-1.64]), and anxiety ( β : 1.57 [1.07-2.07]), exceeding the MIDs thresholds (5-10 points).

CONCLUSIONS

Our results suggest that greater 6MWT performance and upper-body muscle strength are associated with better functioning and lower symptom burden. Additionally, greater aerobic fitness was linked to better cognitive function. These findings underscore the potential importance of physical fitness for quality of life in cancer survivors and highlight the need for future interventional studies to determine whether improving fitness through rehabilitation strategies can enhance patient outcomes.