Originally published as JCO Early Release 10.1200/JCO.2006.06.0863 on July 5 2006

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Impact of Physical Activity on Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From CALGB 89803

Jeffrey A. Meyerhardt, Denise Heseltine, Donna Niedzwiecki, Donna Hollis, Leonard B. Saltz, Robert J. Mayer, James Thomas, Heidi Nelson, Renaud Whittom, Alexander Hantel, Richard L. Schilsky, Charles S. Fuchs

From the Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Cancer and Leukemia Group B Statistical Center, Duke University, Durham, NC; Memorial Sloan-Kettering Cancer Center, New York, NY; Division of Medical Oncology, Ohio State University, Columbus, OH; Division of Colon and Rectal Surgery, Mayo Clinic Foundation, Rochester MN; Hôpital du Sacré-Coeur de Montréal, Montreal, Ontario, Canada; Department of Medicine, Loyola University, Maywood; and Section of Hematology/Oncology, University of Chicago, Chicago, IL

Address reprint requests to Jeffrey A. Meyerhardt, MD, MPH, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115; e-mail: jmeyerhardt{at}partners.org

PURPOSE: Regular physical activity reduces the risk of developing colon cancer, however, its influence on patients with established disease is unknown.

PATIENTS AND 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.

CONCLUSION: 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.

Supported in part by the National Cancer Institute (Grant No. CA31946) to the Cancer and Leukemia Group B (Richard L. Schilsky, MD, Chairman) and Pharmacia & Upjohn Company, now Pfizer Oncology. Supported in part by a K07 award from the National Cancer Institute (Grant No. 1K07CA097992-01A1) and an American Society of Clinical Oncology Career Development Award (J.A.M.).

Article contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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