TY - JOUR
T1 - Evaluating the Impact of Post-Esophagectomy Exercise on 2- and 5-Yr Survival
T2 - Findings from the PERFECT Trial
AU - Binyam, David
AU - van Vulpen, J K
AU - van Hillegersberg, R
AU - Ruurda, J P
AU - Nieuwenhuijzen, G A P
AU - Kouwenhoven, E A
AU - van der Wall, E
AU - Groenendijk, R P R
AU - van der Peet, D L
AU - Rosman, C
AU - Wijnhoven, B P L
AU - van Berge Henegouwen, M I
AU - van Laarhoven, H W M
AU - Siersema, P D
AU - May, Anne M
AU - Hiensch, A E
N1 - Publisher Copyright:
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.
PY - 2025/2/1
Y1 - 2025/2/1
N2 - Purpose Despite recent treatment advances, esophageal cancer still has poor survival and a high morbidity. Exploratory evidence suggests that exercise can reduce cancer-related mortality and recurrence rates. Here, we investigated the effects of an exercise intervention in the first year after esophagectomy on survival in participants of the Physical ExeRcise Following Esophageal Cancer Treatment (PERFECT) trial. Methods In the PERFECT trial, esophageal cancer patients who had undergone esophagectomy were randomized to a 12-wk exercise program (EX) or the control group (CG). We assessed 2- and 5-yr (progression-free) survival. (Un)adjusted Cox proportional-hazards models were used to calculate hazard ratios (HRs) for comparison between the trial arms. Sensitivity analyses, excluding patients with events within the exercise intervention period, were performed. Results In total, 120 participants (EX = 61; CG = 59) were included in the PERFECT trial. After 2-yr follow-up, no significant difference in the risk of death or progression between EX and CG was found (adjusted HR = 1.65 (95% confidence interval (CI), 0.75-3.63) and 1.38 (95% CI, 0.76-2.50), respectively). After excluding patients with events during the intervention period (EX = 8; CG = 4), 2-yr HRs for death (1.03; 95% CI, 0.41-2.56) and progression (1.26; 95% CI, 0.64-2.48) both decreased and remained insignificant. No significant effects were found on 5-yr mortality (1.03; 95% CI, 0.57-1.84) and progression (1.21; 95% CI, 0.72-2.04) either. Sensitivity analysis resulted in attenuated 5-yr HRs for mortality (0.82; 95% CI, 0.42-1.58) and progression (1.08; 95% CI, 0.61-1.92). Conclusions The results indicate no benefit of a 12-wk exercise program in the first year post-esophagectomy on 2- and 5-yr (progression-free) survival in esophageal cancer patients. The absence of beneficial effects may be explained by the relatively short exercise program, which was performed after treatment completion.
AB - Purpose Despite recent treatment advances, esophageal cancer still has poor survival and a high morbidity. Exploratory evidence suggests that exercise can reduce cancer-related mortality and recurrence rates. Here, we investigated the effects of an exercise intervention in the first year after esophagectomy on survival in participants of the Physical ExeRcise Following Esophageal Cancer Treatment (PERFECT) trial. Methods In the PERFECT trial, esophageal cancer patients who had undergone esophagectomy were randomized to a 12-wk exercise program (EX) or the control group (CG). We assessed 2- and 5-yr (progression-free) survival. (Un)adjusted Cox proportional-hazards models were used to calculate hazard ratios (HRs) for comparison between the trial arms. Sensitivity analyses, excluding patients with events within the exercise intervention period, were performed. Results In total, 120 participants (EX = 61; CG = 59) were included in the PERFECT trial. After 2-yr follow-up, no significant difference in the risk of death or progression between EX and CG was found (adjusted HR = 1.65 (95% confidence interval (CI), 0.75-3.63) and 1.38 (95% CI, 0.76-2.50), respectively). After excluding patients with events during the intervention period (EX = 8; CG = 4), 2-yr HRs for death (1.03; 95% CI, 0.41-2.56) and progression (1.26; 95% CI, 0.64-2.48) both decreased and remained insignificant. No significant effects were found on 5-yr mortality (1.03; 95% CI, 0.57-1.84) and progression (1.21; 95% CI, 0.72-2.04) either. Sensitivity analysis resulted in attenuated 5-yr HRs for mortality (0.82; 95% CI, 0.42-1.58) and progression (1.08; 95% CI, 0.61-1.92). Conclusions The results indicate no benefit of a 12-wk exercise program in the first year post-esophagectomy on 2- and 5-yr (progression-free) survival in esophageal cancer patients. The absence of beneficial effects may be explained by the relatively short exercise program, which was performed after treatment completion.
KW - ESOPHAGEAL CANCER
KW - ESOPHAGECTOMY
KW - EXERCISE
KW - SURVIVAL
UR - http://www.scopus.com/inward/record.url?scp=85204924315&partnerID=8YFLogxK
U2 - 10.1249/MSS.0000000000003559
DO - 10.1249/MSS.0000000000003559
M3 - Article
C2 - 39293388
SN - 0195-9131
VL - 57
SP - 327
EP - 336
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
IS - 2
ER -