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-week exercise program (EX) or the control group (CG). We assessed 2- and 5-year (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-year follow-up, no significant difference in the risk of death or progression between EX and CG was found (adjusted HR = 1.65, 95% 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-year 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-year 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-year 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-week exercise program in the first year post-esophagectomy on 2- and 5-year (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.

中文翻译：

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评估食管切除术后锻炼对 2 年和 5 年生存率的影响：来自 PERFECT 试验的结果。


目的尽管最近的治疗取得了进展，但食管癌的生存率仍然很低，发病率很高。探索性证据表明，运动可以降低癌症相关死亡率和复发率。在这里，我们调查了食管癌切除术后第一年的运动干预对食管癌治疗后体育锻炼 (PERFECT) 试验参与者生存的影响。方法 在 PERFECT 试验中，接受食管切除术的食管癌患者被随机分配到为期 12 周的运动计划 (EX) 或对照组 (CG)。我们评估了 2 年和 5 年（无进展）生存率。使用（未）调整的 Cox 比例风险模型来计算风险比 (HR)，以便在试验组之间进行比较。进行了敏感性分析，排除了在运动干预期间发生事件的患者。结果 PERFECT 试验总共纳入了 120 名参与者（EX = 61；CG = 59）。 2 年随访后，未发现 EX 和 CG 之间的死亡或进展风险存在显着差异（调整后 HR = 1.65，95% CI [0.75-3.63] 和 1.38，95% CI [0.76-2.50]，分别）。排除干预期间发生事件的患者（EX = 8；CG = 4）后，死亡（1.03，95% CI [0.41-2.56]）和进展（1.26，95% CI [0.64-2.48]）的 2 年 HR ) 均下降且仍然不显着。对 5 年死亡率（1.03，95% CI [0.57-1.84]）和进展（1.21，95% CI [0.72-2.04]）也没有发现显着影响。敏感性分析得出死亡率（0.82，95% CI [0.42-1.58]）和进展（1.08，95% CI [0.61-1.92]）的 5 年 HR 减弱。 结论 结果表明，食管癌患者术后第一年进行 12 周锻炼计划对 2 年和 5 年（无进展）生存没有益处。缺乏有益效果可能是由于治疗完成后进行的锻炼计划相对较短。