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

Justin C. Brown, LSU Health Sciences Center - New Orleans
Chao Ma, Dana-Farber Cancer Institute
Qian Shi, Mayo Clinic
Charles S. Fuchs, Genentech, Inc
Jeffrey Meyer, Dana-Farber Cancer Institute
Donna Niedzwiecki, Duke University Medical Center
Tyler Zemla, Mayo Clinic
Felix Couture, CHU de Québec - Université Laval
Philip Kuebler, Community Programming
Pankaj Kumar, Illinois Cancer Care
Dequincy Lewis, Cone Health Medical Group
Benjamin Tan, Alvin J. Siteman Cancer Center
Smitha Krishnamurthi, Cleveland Clinic Foundation
Eileen M. O'Reilly, Weill Cornell Medical Center
Anthony F. Shields, Wayne State University
Jeffrey A. Meyerhardt, Dana-Farber Cancer Institute


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.METHODSWe 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.RESULTSDuring 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).CONCLUSIONAmong 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.