Exercise May Close Survival Gap for Colon Cancer Patients

TOPLINE:

Higher levels of physical activity reduced the survival disparity between patients with stage III colon cancer and matched individuals from the general population, a recent study found. However, among patients without tumor recurrence at 3 years, survival rates closely approached that of the general population, regardless of physical activity levels.

METHODOLOGY:

• Research suggests that, in people diagnosed with colon cancer, physical activity can improve disease‐free survival, which may translate to an overall survival benefit. However, whether physical activity during and after treatment can help close the survival gap between those with colon cancer and similar individuals without cancer in the general population remains unclear.
• Researchers analyzed data from 2876 patients (median age at diagnosis, 60.8 years) with stage III colon cancer from two National Cancer Institute–sponsored trials (CALGB 89803 and CALGB 80702).
• Participants reported their physical activity levels, which was quantified in metabolic equivalent (MET) hours per week. The median duration of follow‐up was about 6 years for both CALGB 89803 and CALGB 80702.
• Researchers compared survival rates among patients in the two trials and matched individuals without cancer in the general population. The primary endpoint was overall survival from the first physical activity assessment to death from any cause.

TAKEAWAY:

• Overall, in CALGB 89803, the absolute difference between the observed 3-year survival rate in patients with colon cancer and the expected rate in the matched general population was −11.3%. Higher physical activity reduced this gap — the survival rate in patients with colon cancer was only 3.5% lower than that in the general population among those with ≥ 18.0 MET hours/wk and 17.1% lower among those with < 3.0 MET hours/wk.
• In CALGB 80702, the absolute difference between the observed 3-year survival rate in patients with colon cancer and the expected rate in the general population was −6.6%. As in CALGB 89803, higher levels of physical activity reduced this gap in the highest activity group (to −4.4%).
• For patients with no tumor recurrence at 3 years, “the survival rate approximated the [matched general population], regardless of the volume of physical activity,” the authors said. Those who engaged in higher levels of physical activity had slightly better overall survival rates than the general population (by 2.9%) whereas those with lowest activity levels had slightly lower survival rates than the general population (3.1%).
• Among patients with tumor recurrence at 3 years, the survival rate remained significantly lower than that in the general population (55.8% lower with < 3.0 MET hours/wk and 42.5% lower with ≥ 18.0 MET hours/wk).

IN PRACTICE:

“Among patients with stage III colon cancer enrolled in trials of postoperative treatments, participation in physical activity was associated with an attenuation of the survival disparity between colon cancer patients and the [matched general population]. Achieving a survival rate comparable to the MGP is conditional on remaining tumor recurrence free. Select colon cancer survivors who are physically active may achieve long‐term survival that approximates the MGP,” the authors concluded.

SOURCE:

This study, led by Justin Brown, PhD, Pennington Biomedical Research Center, Baton Rouge, Louisiana, was published online on February 24 in Cancer.

LIMITATIONS:

The observational design limited causal inference. Patients in clinical trials could differ from the general colon cancer population, particularly in having fewer chronic conditions. Physical activity was self-reported and focused on recreational activities.

DISCLOSURES:

This study was supported by grants from the National Cancer Institute of the National Institutes of Health. Several authors declared having various ties with various sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.