Physical activity and survival of colorectal cancer patients: Population-based study from Germany
Physical activity and survival of colorectal cancer patients: Population-based study from Germany
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DOI：
10.1002/ijc.30619
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发表时间：
2017-05-01
影响因子：
6.4
通讯作者：
Brenner, Hermann
中科院分区：
文献类型：
--
作者：
Walter, Viola;Jansen, Lina;Brenner, Hermann
越来越多的证据表明，体育活动与改善结直肠癌（CRC）预后有关。然而，大规模的前瞻性患者队列，全面确定身体活动，全面考虑CRC分期的潜在变化，并考虑具体的结局措施，是稀缺的。因此，我们的目的是在一个以人群为基础的CRC患者队列中评估终生和最新诊断前休闲时间体力活动与相关预后结果的关系。对2003-2010年诊断为结直肠癌的3121例患者（中位年龄：69岁）进行了社会人口统计学和生活方式因素、药物和合并症的访谈。癌症复发、生命体征和死亡原因的中位随访时间为4.8年。使用Cox回归评估终生和最新诊断前休闲时间体力活动与总体、crc特异性、无复发和无病生存之间的关系。最近但不是一生的闲暇时间体力活动[每周代谢任务小时数（MET-h/周）]与总体死亡率和crc特异性死亡率降低相关(步行56.2 vs. 20 vs. 0-10 MET-h/周：aHR（总体/最新）= 0.66；95% ci50.56 - 0.77;aHR(CRC-specific/latest) = 0.72；95% ci50.60 - 0.87;aHR（总体/寿命）= 0.78；95% ci50.66 - 0.93;aHR（crc特异性/终生）= 0.71；95% ci = 0.58-0.86)。这种关联在转移性（IV期）患者终生行走和非转移性疾病患者最近一次行走中尤为明显。诊断前体育活动与CRC预后改善相关。关联可能仅限于某些活动或依赖于（非）转移性疾病状态。进一步优化运动建议，提高建议依从性，可能有助于改善患者预后。
Increasing evidence shows physical activity to be associated with improved colorectal cancer (CRC) prognosis. However, large-scale prospective patient cohorts, comprehensively ascertaining physical activity, comprehensively considering potential variation by CRC stage and considering specific outcome measures, are sparse. Therefore, we aimed to evaluate the association of lifetime and latest prediagnostic leisure time physical activity with relevant prognostic outcomes in a large population-based cohort of CRC patients. 3,121 patients, diagnosed with CRC in 2003-2010 (median age: 69 years), were interviewed on sociodemographic and lifestyle factors, medication and comorbidities. Cancer recurrence, vital status and cause of death were documented over a median follow-up time of 4.8 years. Associations between lifetime and latest prediagnostic leisure time physical activity and overall, CRC-specific, recurrence-free and disease-free survival were evaluated with Cox regression. Latest but not lifetime leisure time physical activity [in metabolic task hours per week (MET-h/wk)] was associated with decreased overall and CRC-specific mortality (>56.2 vs. 20 vs. 0-10 MET-h/wk of walking: aHR(Overall/latest) = 0.66; 95% CI50.56-0.77; aHR(CRC-specific/latest) = 0.72; 95% CI50.60-0.87; aHR(Overall/lifetime) = 0.78; 95% CI50.66-0.93; aHR(CRC-specific/lifetime) = 0.71; 95% CI = 0.58-0.86). Associations were particularly pronounced for lifetime walking in metastatic (stage IV) and for latest walking in nonmetastatic disease patients. Prediagnostic physical activity was associated with improved CRC prognosis. Associations might be restricted to certain activities or depend on (non) metastatic disease state. Further optimization of activity recommendations and increase of recommendation adherence may help to improve patients' prognosis.