Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

Authors: Moniek van Zutphen, Renate M. Winkels, Fränzel J. B. van Duijnhoven, Suzanne A. van Harten-Gerritsen, Dieuwertje E. G. Kok, Peter van Duijvendijk, Henk K. van Halteren, Bibi M. E. Hansson, Flip M. Kruyt, Ernst J. Spillenaar Bilgen, Johannes H. W. de Wilt, Jaap J. Dronkers, Ellen Kampman

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

The influence of physical activity on patient-reported recovery of physical functioning after colorectal cancer (CRC) surgery is unknown. Therefore, we studied recovery of physical functioning after hospital discharge by (a) a relative increase in physical activity level and (b) absolute activity levels before and after surgery.

Methods

We included 327 incident CRC patients (stages I–III) from a prospective observational study. Patients completed questionnaires that assessed physical functioning and moderate-to-vigorous physical activity shortly after diagnosis and 6 months later. Cox regression models were used to calculate prevalence ratios (PRs) of no recovery of physical functioning. All PRs were adjusted for age, sex, physical functioning before surgery, stage of disease, ostomy and body mass index.

Results

At 6 months post-diagnosis 54% of CRC patients had not recovered to pre-operative physical functioning. Patients who increased their activity by at least 60 min/week were 43% more likely to recover physical function (adjusted PR 0.57 95%CI 0.39–0.82), compared with those with stable activity levels. Higher post-surgery levels of physical activity were also positively associated with recovery (P for trend = 0.01). In contrast, activity level before surgery was not associated with recovery (P for trend = 0.24).

Conclusions

At 6 month post-diagnosis, about half of CRC patients had not recovered to preoperative functioning. An increase in moderate-to-vigorous physical activity after CRC surgery was associated with enhanced recovery of physical functioning. This benefit was seen regardless of physical activity level before surgery. These associations provide evidence to further explore connections between physical activity and recovery from CRC surgery after discharge from the hospital.
Literature
1.
Lee L, Tran T, Mayo NE, Carli F, Feldman LS. What does it really mean to “recover” from an operation? Surgery. 2014;155(2):211–6.CrossRefPubMed
2.
Miller TE, Mythen M. Successful recovery after major surgery: Moving beyond length of stay. Perioper Med (Lond). 2014;3:4.CrossRef
3.
Neville A, Lee L, Antonescu I, et al. Systematic review of outcomes used to evaluate enhanced recovery after surgery. Br J Surg. 2014;101(3):159–70.CrossRefPubMed
4.
Covinsky KE, Pierluissi E, Johnston CB. Hospitalization-associated disability: “She was probably able to ambulate, but i’m not sure”. JAMA. 2011;306(16):1782–93.CrossRefPubMed
5.
Given B, Given C, Azzouz F, Stommel M. Physical functioning of elderly cancer patients prior to diagnosis and following initial treatment. Nurs Res. 2001;50(4):222–32.CrossRefPubMed
6.
Johnson BL, Trentham-Dietz A, Koltyn KF, Colbert LH. Physical activity and function in older, long-term colorectal cancer survivors. Cancer Causes Control. 2009;20(5):775–84.CrossRefPubMedPubMedCentral
7.
Oliphant SS, Lowder JL, Lee M, Ghetti C. Most older women recover baseline functional status following pelvic organ prolapse surgery. Int Urogynecol J. 2014;25(10):1425–32.CrossRefPubMed
8.
WHO. International classification of functioning, disability and health. Geneva: World Health Organization; 2001.
9.
Andersson J, Angenete E, Gellerstedt M, et al. Health-related quality of life after laparoscopic and open surgery for rectal cancer in a randomized trial. Br J Surg. 2013;100(7):941–9.CrossRefPubMedPubMedCentral
10.
Janson M, Lindholm E, Anderberg B, Haglind E. Randomized trial of health-related quality of life after open and laparoscopic surgery for colon cancer. Surg Endosc. 2007;21(5):747–53.CrossRefPubMed
11.
Lawrence VA, Hazuda HP, Cornell JE, et al. Functional independence after major abdominal surgery in the elderly. J Am Coll Surg. 2004;199(5):762–72.CrossRefPubMed
12.
Dronkers JJ, Chorus AM, van Meeteren NL, Hopman-Rock M. The association of pre-operative physical fitness and physical activity with outcome after scheduled major abdominal surgery. Anaesthesia. 2013;68(1):67–73.CrossRefPubMed
13.
Wilson TR, Alexander DJ. Clinical and non-clinical factors influencing postoperative health-related quality of life in patients with colorectal cancer. Br J Surg. 2008;95(11):1408–15.CrossRefPubMed
14.
Tak E, Kuiper R, Chorus A, Hopman-Rock M. Prevention of onset and progression of basic adl disability by physical activity in community dwelling older adults: A meta-analysis. Ageing Res Rev. 2013;12(1):329–38.CrossRefPubMed
15.
Paterson DH, Warburton DE. Physical activity and functional limitations in older adults: A systematic review related to canada’s physical activity guidelines. Int J Behav Nutr Phys Act. 2010;7:38.CrossRefPubMedPubMedCentral
16.
Peddle CJ, Au HJ, Courneya KS. Associations between exercise, quality of life, and fatigue in colorectal cancer survivors. Dis Colon Rectum. 2008;51(8):1242–8.CrossRefPubMed
17.
Grimmett C, Bridgewater J, Steptoe A, Wardle J. Lifestyle and quality of life in colorectal cancer survivors. Qual Life Res. 2011;20(8):1237–45.CrossRefPubMed
18.
Lynch BM, Cerin E, Owen N, Aitken JF. Associations of leisure-time physical activity with quality of life in a large, population-based sample of colorectal cancer survivors. Cancer Causes Control. 2007;18(7):735–42.CrossRefPubMed
19.
Courneya KS, Friedenreich CM. Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med. 1997;3(3):215–26.CrossRefPubMed
20.
Vallance JK, Boyle T, Courneya KS, Lynch BM. Associations of objectively assessed physical activity and sedentary time with health-related quality of life among colon cancer survivors. Cancer. 2014;120(18):2919–26.CrossRefPubMed
21.
Buffart LM, Thong MS, Schep G, Chinapaw MJ, Brug J, van de Poll-Franse LV. Self-reported physical activity: Its correlates and relationship with health-related quality of life in a large cohort of colorectal cancer survivors. PLoS One. 2012;7(5):e36164.CrossRefPubMedPubMedCentral
22.
Winkels RM, Heine-Broring RC, van Zutphen M, et al. The colon study: Colorectal cancer: Longitudinal, observational study on nutritional and lifestyle factors that may influence colorectal tumour recurrence, survival and quality of life. BMC Cancer. 2014;14(1):374.CrossRefPubMedPubMedCentral
23.
Aaronson NK, Ahmedzai S, Bergman B, et al. The european organization for research and treatment of cancer qlq-c30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365–76.CrossRefPubMed
24.
Fayers PM, Aaronson NK, Bjordal K, et al. The eortc qlq-c30 scoring manual. 3rd ed. Brussels: European Organisation for Research and Treatment of Cancer; 2001.
25.
Cocks K, King MT, Velikova G, et al. Evidence-based guidelines for interpreting change scores for the european organisation for the research and treatment of cancer quality of life questionnaire core 30. Eur J Cancer. 2012;48(11):1713–21.CrossRefPubMed
26.
Wendel-Vos GC, Schuit AJ, Saris WH, Kromhout D. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003;56(12):1163–9.CrossRefPubMed
27.
Wagenmakers R, van den Akker-Scheek I, Groothoff JW, et al. Reliability and validity of the short questionnaire to assess health-enhancing physical activity (squash) in patients after total hip arthroplasty. BMC Musculoskelet Disord. 2008;9:141.CrossRefPubMedPubMedCentral
28.
de Hollander EL, Zwart L, de Vries SI, Wendel-Vos W. The squash was a more valid tool than the obin for categorizing adults according to the dutch physical activity and the combined guideline. J Clin Epidemiol. 2012;65(1):73–81.CrossRefPubMed
29.
Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 compendium of physical activities: A second update of codes and met values. Med Sci Sports Exerc. 2011;43(8):1575–81.CrossRefPubMed
30.
Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.CrossRefPubMedPubMedCentral
31.
Bhalla A, Williams JP, Hurst NG, et al. One-third of patients fail to return to work 1 year after surgery for colorectal cancer. Tech Coloproctol. 2014;18(12):1153–9.CrossRefPubMed
32.
Ulander K, Jeppsson B, Grahn G. Quality of life and independence in activities of daily living preoperatively and at follow-up in patients with colorectal cancer. Support Care Cancer. 1997;5(5):402–9.CrossRefPubMed
33.
Kopp I, Bauhofer A, Koller M. Understanding quality of life in patients with colorectal cancer: Comparison of data from a randomised controlled trial, a population based cohort study and the norm reference population. Inflamm Res. 2004;53 Suppl 2:S130–5.PubMed
34.
Phillips BE, Smith K, Liptrot S, et al. Effect of colon cancer and surgical resection on skeletal muscle mitochondrial enzyme activity in colon cancer patients: A pilot study. J Cachexia Sarcopenia Muscle. 2013;4(1):71–7.CrossRefPubMed
35.
Onerup A, Bock D, Borjesson M, et al. Is preoperative physical activity related to post-surgery recovery?-a cohort study of colorectal cancer patients. Int J Colorectal Dis. 2016;31(6):1131–40.CrossRefPubMed
36.
Boereboom C, Doleman B, Lund JN, Williams JP. Systematic review of pre-operative exercise in colorectal cancer patients. Tech Coloproctol. 2016;20(2):81–9.CrossRefPubMed
37.
Terwee CB, Bot SD, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.CrossRefPubMed
38.
Bours MJ, Beijer S, Winkels RM, et al. Dietary changes and dietary supplement use, and underlying motives for these habits reported by colorectal cancer survivors of the Patient Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship (PROFILES) registry. Br J Nutr. 2015;114(2):286–96.CrossRefPubMed
Metadata
Title
An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study
Authors
Moniek van Zutphen
Renate M. Winkels
Fränzel J. B. van Duijnhoven
Suzanne A. van Harten-Gerritsen
Dieuwertje E. G. Kok
Peter van Duijvendijk
Henk K. van Halteren
Bibi M. E. Hansson
Flip M. Kruyt
Ernst J. Spillenaar Bilgen
Johannes H. W. de Wilt
Jaap J. Dronkers
Ellen Kampman
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3066-2

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue

Research article

Hybrid clone cells derived from human breast epithelial cells and human breast cancer cells exhibit properties of cancer stem/initiating cells

Research article

Effects of aspirin and non-aspirin nonsteroidal anti-inflammatory drugs on the incidence of recurrent colorectal adenomas: a systematic review with meta-analysis and trial sequential analysis of randomized clinical trials

Research article

Simultaneous analysis of miRNA-mRNA in human meningiomas by integrating transcriptome: A relationship between PTX3 and miR-29c

Research article

Which symptoms are linked to a delayed presentation among melanoma patients? A retrospective study

Research article

Current guidelines for BRCA testing of breast cancer patients are insufficient to detect all mutation carriers

Research article

The association between high birth weight and the risks of childhood CNS tumors and leukemia: an analysis of a US case-control study in an epidemiological database
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits