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

Karel C. Smit, Jeroen W.G. Derksen, PLCRC study group, Geerard L.O. Beets, Eric J.Th Belt, Maaike Berbée, Peter Paul L.O. Coene, Hester Van Cruijsen, Marjan A. Davidis, Jan Willem T. Dekker, Joyce M. Van Dodewaard-De Jong, Annebeth W. Haringhuizen, Helgi H. Helgason, Mathijs P. Hendriks, Ronald Hoekstra, Ignace H.J.T. De Hingh, Jan N.M. Ijzermans, Johan J.B. Janssen, Joop L.M. Konsten, Maartje LosLeonie J.M. Mekenkamp, Peter Nieboer, Koen C.M.J. Peeters, Natascha A.J.B. Peters, Hans J.F.M. Pruijt, Patricia Quarles Van Ufford-Mannesse, Ron C. Rietbroek, Anandi H.W. Schiphorst, Arjan Schouten Van Der Velden, Ruud W.M. Schrauwen, Mark P.S. Sie, Dirkje W. Sommeijer, Dirk J.A. Sonneveld, Hein B.A.C. Stockmann, Marleen Tent, Frederiek Terheggen, Manuel L.R. Tjin-A-Ton, Liselot Valkenburg-Van Iersel, Ankie M.T. Van Der Velden, Wouter J. Vles, Theo Van Voorthuizen, Johannes A. Wegdam, Johannes H.W. De Wilt, Miriam Koopman, Anne M. May*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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.

Original languageEnglish
Article number1001
JournalCancers
Volume14
Issue number4
DOIs
Publication statusPublished - 16 Feb 2022

Bibliographical 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).

Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

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