Physical Activity in Stage III Colon Cancer: CALGB/SWOG 80702 (Alliance)

Author(s): Justin C. Brown, PhD^1,2,3;Chao Ma, MS⁴;Qian Shi, PhD⁵;Charles S. Fuchs, MD, MPH⁶;Jeffrey Meyer, BS⁴;Donna Niedzwiecki, PhD⁷;Tyler Zemla, MS⁵;Felix Couture, MD⁸;Philip Kuebler, MD⁹;Pankaj Kumar, MD¹⁰;DeQuincy Lewis, MD¹¹;Benjamin Tan, MD¹²;Smitha Krishnamurthi, MD¹³;Eileen M. O’Reilly, MD¹⁴;Anthony F. Shields, MD¹⁵;and Jeffrey A. Meyerhardt, MD, MPH⁴

Source: DOI: 10.1200/JCO.22.00171 Journal of Clinical Oncology 41, no. 2 (January 10, 2023) 243-254.

Dr. Anjan Patel's Thoughts

Get your patients moving, even in the adjuvant setting! Of course, a lot of bias is possible here, but there was nearly a 10% difference in cure at three years.

PURPOSE

To determine the specific types, durations, and intensities of recreational physical activity associated with the greatest improvements in disease-free survival (DFS) of patients with colon cancer.

METHODS

We conducted a prospective cohort study nested within a randomized multicenter trial of stage III colon cancer that compared 3 versus 6 months of fluorouracil, leucovorin, and oxaliplatin with or without celecoxib. We measured recreational physical activity in the first 3 months of chemotherapy and again 6 months after completion of chemotherapy. The primary end point was DFS.

RESULTS

During a median follow-up of 5.9 years, 457 of 1,696 patients experienced disease recurrence or death. For total recreational physical activity volume, the 3-year DFS was 76.5% with < 3.0 metabolic equivalent task hours per week (MET-h/wk) and 87.1% with ≥ 18.0 MET-h/wk (risk difference [RD], 10.6%; 95% CI, 4.7 to 19.4; P < .001). For light-intensity to moderate-intensity activities, the 3-year DFS was 65.7% with 0.0 h/wk and 87.1% with ≥ 1.5 h/wk (RD, 21.4%; 95% CI, 9.2 to 37.1; P < .001). For vigorous-intensity activity, the 3-year DFS was 76.0% with 0.0 h/wk and 86.0% with ≥ 1.0 h/wk (RD, 10.0%; 95% CI, 4.5 to 18.9; P < .001). For brisk walking, the 3-year DFS was 81.7% with < 1.0 h/wk and 88.4% with ≥ 3.0 h/wk (RD, 6.7%; 95% CI, 3.0 to 13.8; P < .001). For muscle strengthening activity, the 3-year DFS was 81.8% with 0.0 h/wk and 88.8% for ≥ 0.5 h/wk (RD, 7.0%; 95% CI, 3.1 to 14.2; P = .003).

CONCLUSION

Among patients with stage III colon cancer enrolled in a trial of postoperative treatment, larger volumes of recreational physical activity, longer durations of light- to moderate-intensity aerobic physical activity, or any vigorous-intensity aerobic physical activity were associated with the greatest improvements in DFS.

Author Affiliations

¹Pennington Biomedical Research Center, Baton Rouge, LA;²LSU Health Sciences Center New Orleans School of Medicine, New Orleans, LA;³Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA;⁴Dana-Farber/Partners CancerCare, Boston, MA;⁵Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN;⁶Genentech, Inc, South San Francisco, CA;⁷Duke University Medical Center, Durham, NC;⁸Hôtel-Dieu de Québec, Québec, QC, Canada;⁹Columbus NCI Community Oncology Research Program, Columbus, OH;¹⁰Illinois CancerCare PC, Peoria, IL;¹¹Cone Health Medical Group, Asheboro, NC;¹²Siteman Cancer Center, Washington University School of Medicine in St Louis, Saint Louis, MO;¹³Cleveland Clinic, Cleveland, OH;¹⁴Memorial Sloan Kettering Cancer Center, Weill Cornell Medical Center, New York, NY;¹⁵Karmanos Cancer Institute, Wayne State University, Detroit, MI

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