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Impact of physical activity on cancer-specific and overall survival of patients with colorectal cancer.

Des Guetz G, Uzzan B, Bouillet T, Nicolas P, Chouahnia K, Zelek L, Morere JF - Gastroenterol Res Pract (2013)

Bottom Line: No dedicated MA was found in the Cochrane Library.When higher PA was associated with improved survival, HRs for detrimental events were set to <1.OS also improved (reduced cardiovascular risk).

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, APHP, Avicenne Hospital, 125 route de Stalingrad, 125 rue de Stalingrad, 93009 Bobigny, France.

ABSTRACT
Background. Physical activity (PA) reduces incidence of colorectal cancer (CRC). Its influence on cancer-specific (CSS) and overall survival (OS) is controversial. Methods. We performed a literature-based meta-analysis (MA) of observational studies, using keywords "colorectal cancer, physical activity, and survival" in PubMed and EMBASE. No dedicated MA was found in the Cochrane Library. References were cross-checked. Pre- and postdiagnosis PA levels were assessed by MET. Usually, "high" PA was higher than 17 MET hour/week. Hazard ratios (HRs) for OS and CSS were calculated, with their 95% confidence interval. We used more conservative adjusted HRs, since variables of adjustment were similar between studies. When higher PA was associated with improved survival, HRs for detrimental events were set to <1. We used EasyMA software and fixed effect model whenever possible. Results. Seven studies (8056 participants) were included, representing 3762 men and 4256 women, 5210 colon and 1745 rectum cancers. Mean age was 67 years. HR CSS for postdiagnosis PA (higher PA versus lower) was 0.61 (0.44-0.86). The corresponding HR OS was 0.62 (0.54-0.71). HR CSS for prediagnosis PA was 0.75 (0.62-0.91). The corresponding HR OS was 0.74 (0.62-0.89). Conclusion. Higher PA predicted a better CSS. Sustained PA should be advised for CRC. OS also improved (reduced cardiovascular risk).

No MeSH data available.


Related in: MedlinePlus

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Mentions: The most expected result of this MA concerned the search for a relationship between PA performed after CRC diagnosis and CSS. Only 3 out of the 6 individual studies assessing postdiagnosis PA found a statistically significant increase in CSS among patients with a high level of PA compared to patients with a low level. Overall, higher postdiagnosis PA was significantly associated with an improved CSS (HR CSS = 0.61, 0.44–0.86; random-effect model; P < 0.001). A random-effect model was used since a fixed-effect model led to statistically significant between-study heterogeneity. Finally, higher postdiagnosis PA level was associated with a significantly increased OS (HR OS = 0.62, 0.54–0.71; fixed-effect model; P < 0.001). Five out of 6 individual studies assessing the relationship between PA level and OS found a statistically significant increase in OS among patients with higher postdiagnosis PA levels (Figures 1, 2, 3, and 4).


Impact of physical activity on cancer-specific and overall survival of patients with colorectal cancer.

Des Guetz G, Uzzan B, Bouillet T, Nicolas P, Chouahnia K, Zelek L, Morere JF - Gastroenterol Res Pract (2013)

© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3814048&req=5

Mentions: The most expected result of this MA concerned the search for a relationship between PA performed after CRC diagnosis and CSS. Only 3 out of the 6 individual studies assessing postdiagnosis PA found a statistically significant increase in CSS among patients with a high level of PA compared to patients with a low level. Overall, higher postdiagnosis PA was significantly associated with an improved CSS (HR CSS = 0.61, 0.44–0.86; random-effect model; P < 0.001). A random-effect model was used since a fixed-effect model led to statistically significant between-study heterogeneity. Finally, higher postdiagnosis PA level was associated with a significantly increased OS (HR OS = 0.62, 0.54–0.71; fixed-effect model; P < 0.001). Five out of 6 individual studies assessing the relationship between PA level and OS found a statistically significant increase in OS among patients with higher postdiagnosis PA levels (Figures 1, 2, 3, and 4).

Bottom Line: No dedicated MA was found in the Cochrane Library.When higher PA was associated with improved survival, HRs for detrimental events were set to <1.OS also improved (reduced cardiovascular risk).

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, APHP, Avicenne Hospital, 125 route de Stalingrad, 125 rue de Stalingrad, 93009 Bobigny, France.

ABSTRACT
Background. Physical activity (PA) reduces incidence of colorectal cancer (CRC). Its influence on cancer-specific (CSS) and overall survival (OS) is controversial. Methods. We performed a literature-based meta-analysis (MA) of observational studies, using keywords "colorectal cancer, physical activity, and survival" in PubMed and EMBASE. No dedicated MA was found in the Cochrane Library. References were cross-checked. Pre- and postdiagnosis PA levels were assessed by MET. Usually, "high" PA was higher than 17 MET hour/week. Hazard ratios (HRs) for OS and CSS were calculated, with their 95% confidence interval. We used more conservative adjusted HRs, since variables of adjustment were similar between studies. When higher PA was associated with improved survival, HRs for detrimental events were set to <1. We used EasyMA software and fixed effect model whenever possible. Results. Seven studies (8056 participants) were included, representing 3762 men and 4256 women, 5210 colon and 1745 rectum cancers. Mean age was 67 years. HR CSS for postdiagnosis PA (higher PA versus lower) was 0.61 (0.44-0.86). The corresponding HR OS was 0.62 (0.54-0.71). HR CSS for prediagnosis PA was 0.75 (0.62-0.91). The corresponding HR OS was 0.74 (0.62-0.89). Conclusion. Higher PA predicted a better CSS. Sustained PA should be advised for CRC. OS also improved (reduced cardiovascular risk).

No MeSH data available.


Related in: MedlinePlus