Physical activity and outcomes in patients with stage III colon cancer: A correlative analysis of phase III trial NCCTG N0147 (Alliance)

Amanda I. Phipps, Qian D Shi, Tyler J. Zemla, Efrat Dotan, Sharlene Gill, Richard M. Goldberg, Sheetal Hardikar, Balkrishna Jahagirdar, Paul John Limburg, Polly A. Newcomb, Anthony Shields, Frank A Sinicrope, Daniel J. Sargent, Steven Robert Alberts

Research output: Contribution to journalArticle

Abstract

Background: Prior studies have supported an inverse association between physical activity and colon cancer risk and suggest that higher physical activity May also improve cancer survival. Among participants in a phase III adjuvant trial for stage III colon cancer, we assessed the association of physical activity around the time of cancer diagnosis with subsequent outcomes. Methods: Before treatment arm randomization (FOLFOX or FOLFOX þ cetuximab), study participants completed a questionnaire including items regarding usual daily activity level and frequency of participation in recreational physical activity (N ¼ 1,992). Using multivariable Cox models, we calculated HRs for associations of aspects of physical activity with disease-free (DFS) and overall survival (OS). Results: Over follow-up, 505 participants died and 541 experienced a recurrence. Overall, 75% of participants reported recreational physical activity at least several times a month; for participants who reported physical activity at least that often (vs. once a month or less), the HRs for DFS and OS were 0.82 [95% confidence interval (CI), 0.69–0.99] and 0.76 (95% CI, 0.63–0.93), respectively. There was no evidence of material effect modification in these associations by patient or tumor attributes, except that physical activity was more strongly inversely associated with OS in patients with stage T3 versus T4 tumors (Pinteraction ¼ 0.03). Conclusions: These findings suggest that higher physical activity around the time of colon cancer diagnosis May be associated with more favorable colon cancer outcomes. Impact: Our findings support further research on whether colon cancer survival May be enhanced by physical activity. Cancer Epidemiol Biomarkers Prev; 27(6); 696–703. 2018 AACR.

Original languageEnglish (US)
Pages (from-to)696-703
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Volume27
Issue number6
DOIs
StatePublished - Jun 1 2018

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Colonic Neoplasms
Exercise
Survival
Neoplasms
Confidence Intervals
Tumor Biomarkers
Random Allocation
Proportional Hazards Models
Recurrence
Research

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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Physical activity and outcomes in patients with stage III colon cancer : A correlative analysis of phase III trial NCCTG N0147 (Alliance). / Phipps, Amanda I.; Shi, Qian D; Zemla, Tyler J.; Dotan, Efrat; Gill, Sharlene; Goldberg, Richard M.; Hardikar, Sheetal; Jahagirdar, Balkrishna; Limburg, Paul John; Newcomb, Polly A.; Shields, Anthony; Sinicrope, Frank A; Sargent, Daniel J.; Alberts, Steven Robert.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 27, No. 6, 01.06.2018, p. 696-703.

Research output: Contribution to journalArticle

Phipps, Amanda I. ; Shi, Qian D ; Zemla, Tyler J. ; Dotan, Efrat ; Gill, Sharlene ; Goldberg, Richard M. ; Hardikar, Sheetal ; Jahagirdar, Balkrishna ; Limburg, Paul John ; Newcomb, Polly A. ; Shields, Anthony ; Sinicrope, Frank A ; Sargent, Daniel J. ; Alberts, Steven Robert. / Physical activity and outcomes in patients with stage III colon cancer : A correlative analysis of phase III trial NCCTG N0147 (Alliance). In: Cancer Epidemiology Biomarkers and Prevention. 2018 ; Vol. 27, No. 6. pp. 696-703.
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abstract = "Background: Prior studies have supported an inverse association between physical activity and colon cancer risk and suggest that higher physical activity May also improve cancer survival. Among participants in a phase III adjuvant trial for stage III colon cancer, we assessed the association of physical activity around the time of cancer diagnosis with subsequent outcomes. Methods: Before treatment arm randomization (FOLFOX or FOLFOX {\th} cetuximab), study participants completed a questionnaire including items regarding usual daily activity level and frequency of participation in recreational physical activity (N ¼ 1,992). Using multivariable Cox models, we calculated HRs for associations of aspects of physical activity with disease-free (DFS) and overall survival (OS). Results: Over follow-up, 505 participants died and 541 experienced a recurrence. Overall, 75{\%} of participants reported recreational physical activity at least several times a month; for participants who reported physical activity at least that often (vs. once a month or less), the HRs for DFS and OS were 0.82 [95{\%} confidence interval (CI), 0.69–0.99] and 0.76 (95{\%} CI, 0.63–0.93), respectively. There was no evidence of material effect modification in these associations by patient or tumor attributes, except that physical activity was more strongly inversely associated with OS in patients with stage T3 versus T4 tumors (Pinteraction ¼ 0.03). Conclusions: These findings suggest that higher physical activity around the time of colon cancer diagnosis May be associated with more favorable colon cancer outcomes. Impact: Our findings support further research on whether colon cancer survival May be enhanced by physical activity. Cancer Epidemiol Biomarkers Prev; 27(6); 696–703. 2018 AACR.",
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T1 - Physical activity and outcomes in patients with stage III colon cancer

T2 - A correlative analysis of phase III trial NCCTG N0147 (Alliance)

AU - Phipps, Amanda I.

AU - Shi, Qian D

AU - Zemla, Tyler J.

AU - Dotan, Efrat

AU - Gill, Sharlene

AU - Goldberg, Richard M.

AU - Hardikar, Sheetal

AU - Jahagirdar, Balkrishna

AU - Limburg, Paul John

AU - Newcomb, Polly A.

AU - Shields, Anthony

AU - Sinicrope, Frank A

AU - Sargent, Daniel J.

AU - Alberts, Steven Robert

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: Prior studies have supported an inverse association between physical activity and colon cancer risk and suggest that higher physical activity May also improve cancer survival. Among participants in a phase III adjuvant trial for stage III colon cancer, we assessed the association of physical activity around the time of cancer diagnosis with subsequent outcomes. Methods: Before treatment arm randomization (FOLFOX or FOLFOX þ cetuximab), study participants completed a questionnaire including items regarding usual daily activity level and frequency of participation in recreational physical activity (N ¼ 1,992). Using multivariable Cox models, we calculated HRs for associations of aspects of physical activity with disease-free (DFS) and overall survival (OS). Results: Over follow-up, 505 participants died and 541 experienced a recurrence. Overall, 75% of participants reported recreational physical activity at least several times a month; for participants who reported physical activity at least that often (vs. once a month or less), the HRs for DFS and OS were 0.82 [95% confidence interval (CI), 0.69–0.99] and 0.76 (95% CI, 0.63–0.93), respectively. There was no evidence of material effect modification in these associations by patient or tumor attributes, except that physical activity was more strongly inversely associated with OS in patients with stage T3 versus T4 tumors (Pinteraction ¼ 0.03). Conclusions: These findings suggest that higher physical activity around the time of colon cancer diagnosis May be associated with more favorable colon cancer outcomes. Impact: Our findings support further research on whether colon cancer survival May be enhanced by physical activity. Cancer Epidemiol Biomarkers Prev; 27(6); 696–703. 2018 AACR.

AB - Background: Prior studies have supported an inverse association between physical activity and colon cancer risk and suggest that higher physical activity May also improve cancer survival. Among participants in a phase III adjuvant trial for stage III colon cancer, we assessed the association of physical activity around the time of cancer diagnosis with subsequent outcomes. Methods: Before treatment arm randomization (FOLFOX or FOLFOX þ cetuximab), study participants completed a questionnaire including items regarding usual daily activity level and frequency of participation in recreational physical activity (N ¼ 1,992). Using multivariable Cox models, we calculated HRs for associations of aspects of physical activity with disease-free (DFS) and overall survival (OS). Results: Over follow-up, 505 participants died and 541 experienced a recurrence. Overall, 75% of participants reported recreational physical activity at least several times a month; for participants who reported physical activity at least that often (vs. once a month or less), the HRs for DFS and OS were 0.82 [95% confidence interval (CI), 0.69–0.99] and 0.76 (95% CI, 0.63–0.93), respectively. There was no evidence of material effect modification in these associations by patient or tumor attributes, except that physical activity was more strongly inversely associated with OS in patients with stage T3 versus T4 tumors (Pinteraction ¼ 0.03). Conclusions: These findings suggest that higher physical activity around the time of colon cancer diagnosis May be associated with more favorable colon cancer outcomes. Impact: Our findings support further research on whether colon cancer survival May be enhanced by physical activity. Cancer Epidemiol Biomarkers Prev; 27(6); 696–703. 2018 AACR.

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