Physical activity patterns after diagnosis and survival of prognostic colorectal cancer subgroups.
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Smit Karel C, Derksen Jeroen W G, van Lanen Anne-Sophie, Wesselink Evertine, Belt Eric J Th, Berbée Maaike, Cloos-van Balen Marissa, Dekker Jan Willem T, van Dodewaard Joyce M, Douma Joeri, de Groot Jan Willem, Van Halteren Henk K, Hendriks Mathijs P, De Hingh Ignace H J T, Houtsma Danny, Janssen Johan J B, Konsten Joop L M, Los Maartje, Sie Mark P S, Sommeijer Dirkje, Tanis Pieter J, van der Velden Ankie, Valkenburg-van Iersel Liselot, Vles Wouter J, de Wilt Johannes H W, Kok Dieuwertje E, Kampman Ellen, van Duijnhoven Fränzel J B, Koopman Miriam, May Anne M
Аннотация
METHODS: Data were analyzed from patients in two large CRC cohorts (PLCRC and COLON) enrolled between August 2010 and December 2022 (follow-up until February 1st, 2024). This included 3395 stage I-IIA patients who underwent surgery only, 2406 stage IIB/C-III patients who received (neo-)adjuvant therapy, and 669 metastatic CRC (mCRC) patients. PA was assessed via the validated SQUASH questionnaire at diagnosis (T0), and at 6, 12, and 24 months post-diagnosis (T6 to T24). Moderate-to-vigorous-intensity recreational activity was quantified by calculating Metabolic Equivalent of Task (MET) hours per week. Associations with OS were examined for change (active [tertile 2 and 3] vs inactive [tertile 1]) between timepoints using multivariable Cox proportional hazards models.
RESULTS: Among surgery-only patients, change from inactivity to activity between T0 and T6 was significantly associated with OS (HR = 0.58, 95% CI = 0.35 to 0.96). For (neo-)adjuvantly treated patients, significant associations were observed between T6 and T12 (HR = 0.53, 95% CI = 0.31 to 0.90). Among mCRC patients, a significant association was observed between T6 and T12 (HR = 0.53, 95% CI = 0.29 to 0.99).
CONCLUSION: Changing from inactivity to activity is significantly associated with prolonged survival during the early months post-diagnosis for surgery-only CRC patients, and later for those undergoing (neo-)adjuvant therapy or with metastatic disease. Validation is warranted in interventional studies.