medwireNews: High muscle strength or cardiorespiratory fitness (CRF) levels in people diagnosed with cancer is significantly associated with a decreased risk for all-cause mortality, shows a meta-analysis.
The correlations “were evident when analysing both the cut-off values (ie, high vs low) as well as change per unit increment in physical fitness components,” write Robert Newton (Edith Cowan University, Joondalup, Western Australia) and colleagues in the British Journal of Sports Medicine.
Furthermore, “unit increments in CRF were also associated with a significant reduced risk of cancer-specific mortality,” they highlight.
The team continues: “This underscores the importance of assessing physical fitness in clinical practice for predicting mortality in cancer patients. Moreover, from a practical perspective, implementing tailored exercise prescriptions to enhance muscle strength and CRF throughout the cancer continuum may contribute to reducing cancer-related mortality.”
For the analysis, the researchers identified 42 prospective cohort studies that evaluated the association between muscle strength and/or CRF with mortality in adults with cancer. The included studies comprised a total of 46,694 participants aged a median of 64 years and with a median BMI of 24.8 kg/m2. The majority (n=26) of studies were of multiple cancer types, while nine were limited to lung cancer, two to gastric cancer, and one each to breast, bladder, colon, and pancreatic cancer, and glioma.
In all 26 of the studies that reported on muscle strength, the handgrip strength test was used as the mode of assessment, whereas for CRF, 14 studies used the cardiopulmonary exercise test and four used the 6-min walk test.
Multivariable analysis of the 22 studies that used cut-off values to dichotomize patients by muscle strength showed that those with high muscle strength had a significant 31% reduced risk for all-cause death relative to those with low muscle strength.
Similarly, analysis of seven studies demonstrated that each unit increase in muscle strength correlated with a significant 11% decrease in the all-cause mortality risk.
Thirteen studies were analyzed for the effect of CRF on all-cause mortality and revealed a significant 46% lower risk among people with high versus low CRF.
There was no significant association between unit increases in CRF and all-cause mortality, but data from two studies showed that each unit increment was associated with a significant 18% reduction in the risk for cancer-specific mortality.
“In addition, muscle strength and CRF were associated with an 8–46% reduced risk of all-cause mortality in patients with advanced cancer stages, and a 19–41% reduced risk of all-cause mortality was observed in lung and digestive cancers,” report Newton and associates.
They point out that the findings “are noteworthy especially when considering the detrimental effects of advanced cancer stages, where decreased muscle strength and mass, reduced CRF and heightened fatigue lead to poorer quality of life and increased risk of death.”
Moreover, “considering that lung, colorectal, liver and stomach cancer are among the leading causes of cancer death, our results underscore the relevance of muscle strength as a strong predictor of mortality in aggressive and highly prevalent forms of cancer and may be a priority target for exercise prescription,” say the researchers.
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