title: Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803.
abstract: OBJECTIVE
  Regular physical activity reduces the risk of developing colon cancer, however, its influence on patients with established disease is unknown.
  
  
  METHODS
  We conducted a prospective observational study of 832 patients with stage III colon cancer enrolled in a randomized adjuvant chemotherapy trial. Patients reported on various recreational physical activities approximately 6 months after completion of therapy and were observed for recurrence or death. To minimize bias by occult recurrence, we excluded patients who experienced recurrence or died within 90 days of their physical activity assessment.
  
  
  RESULTS
  Compared with patients engaged in less than three metabolic equivalent task (MET) -hours per week of physical activity, the adjusted hazard ratio for disease-free survival was 0.51 (95% CI, 0.26 to 0.97) for 18 to 26.9 MET-hours per week and 0.55 (95% CI, 0.33 to 0.91) for 27 or more MET-hours per week. The adjusted P for trend was .01. Postdiagnosis activity was associated with similar improvements in recurrence-free survival (P for trend = .03) and overall survival (P for trend = .01). The benefit associated with physical activity was not significantly modified by sex, body mass index, number of positive lymph nodes, age, baseline performance status, or chemotherapy received. Moreover, the benefit remained unchanged even after excluding participants who developed cancer recurrence or died within 6 months of activity assessment.
  
  
  CONCLUSIONS
  Beyond surgical resection and postoperative adjuvant chemotherapy for stage III colon cancer, for patients who survive and are recurrence free approximately 6 months after adjuvant chemotherapy, physical activity appears to reduce the risk of cancer recurrence and mortality.
authors.affiliation: Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA. jmeyerhardt@partners.org
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Meyerhardt
authors.forename: Denise
authors.initials: D
authors.lastname: Heseltine
authors.forename: Donna
authors.initials: D
authors.lastname: Niedzwiecki
authors.forename: Donna
authors.initials: D
authors.lastname: Hollis
authors.forename: Leonard B
authors.initials: LB
authors.lastname: Saltz
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Mayer
authors.forename: James
authors.initials: J
authors.lastname: Thomas
authors.forename: Heidi
authors.initials: H
authors.lastname: Nelson
authors.forename: Renaud
authors.initials: R
authors.lastname: Whittom
authors.forename: Alexander
authors.initials: A
authors.lastname: Hantel
authors.forename: Richard L
authors.initials: RL
authors.lastname: Schilsky
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D018572:Disease-Free Survival; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D019370:Observation; D005082:Physical Exertion; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D011998:Recreation; D016019:Survival Analysis