三分之一的III期结直肠癌患者将经历肿瘤复发。目前尚不确定III期结直肠癌患者在术后化疗期间和之后进行体力活动是否能改善肿瘤复发后的整体生存。本前瞻性队列研究嵌入在一项多中心随机试验中，研究对象为最初诊断为III期结直肠癌并经历肿瘤复发的患者（N=399）。测量了肿瘤复发前的术后体力活动。通过代谢当量任务每周能量消耗量（MET-h/week）来量化体力活动。主要终点为肿瘤复发后的总体生存。多变量灵活参数化生存模型估计了相对效应和绝对效应，并进行了双侧假设检验。 与每周<3.0 MET-h的体力活动相比（相当于每周<1.0小时的快走），每周≥18.0 MET-h的体力活动（相当于每周6小时的快走）的患者在肿瘤复发后的整体生存时间上有33%的相对改善（危害比0.67，95% CI 0.42-0.96）。肿瘤复发后3年的总体生存率为61.3%（95% CI 51.8%-69.2%），每周<3.0 MET-h的体力活动组与72.2%（95% CI 63.1%-79.6%）的≥18 MET-h的体力活动组相比有10.9个百分点的风险差异（95% CI 1.2-20.8个百分点）。 术后更高的体力活动与最初诊断为III期结直肠癌的患者肿瘤复发后的整体生存改善有关。这些数据对那些尽管进行了最佳术后药物治疗但仍然面临较高肿瘤复发风险的患者可能具有相关性。 ©2023美国癌症学会。

One in three patients with stage III colon cancer will experience tumor recurrence. It is uncertain whether physical activity during and after postoperative chemotherapy for stage III colon cancer improves overall survival after tumor recurrence.A prospective cohort study nested within a randomized multicenter trial of patients initially diagnosed with stage III colon cancer who experienced tumor recurrence (N = 399) was conducted. Postoperative physical activity before tumor recurrence was measured. Physical activity energy expenditure was quantified via metabolic equivalent task hours per week (MET-h/week). The primary end point was overall survival after tumor recurrence. Multivariable flexible parametric survival models estimated relative and absolute effects with two-sided hypothesis tests.Compared with patients expending <3.0 MET-h/week of physical activity (comparable to <1.0 h/week of brisk walking), patients with ≥18.0 MET-h/week of physical activity (comparable to 6 h/week of brisk walking) had a 33% relative improvement in overall survival time after tumor recurrence (hazard ratio, 0.67; 95% CI, 0.42-0.96). The overall survival rate at 3 years after tumor recurrence was 61.3% (95% CI, 51.8%-69.2%) with <3.0 MET-h/week of physical activity and 72.2% (95% CI, 63.1%-79.6%) with ≥18 MET-h/week of physical activity (risk difference, 10.9 percentage points; 95% CI, 1.2-20.8 percentage points).Higher postoperative physical activity is associated with improved overall survival after tumor recurrence in patients initially diagnosed with stage III colon cancer. These data may be relevant to patients who, despite optimal postoperative medical therapy, have a high risk of tumor recurrence.© 2023 American Cancer Society.