The Insight Centre for Data Analytics, University College Dublin Belfield, Dublin 4, Dublin, Ireland.
Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan.
Curr Oncol Rep. 2022 Nov;24(11):1645-1659. doi: 10.1007/s11912-022-01287-z. Epub 2022 Aug 10.
Breast cancer (BC) recurrence dramatically decreases 5-year survival, which causes a fear of BC recurrence among a majority of BC survivors. Evidence is currently inconsistent on whether post-diagnosis recreational physical activity (rPA) can prevent BC recurrence due to the small number of included studies, as well as methodological heterogeneity among the studies. This systematic review aimed to clarify the association between post-diagnosis rPA and the risk of BC recurrence, by conducting a meta-analysis while controlling for the categories of rPA across the existing studies.
Prospective cohort studies were searched, and five studies were eligible for the meta-analysis. Of 10,094 patients with BC, 1561 had recurrence during the follow-up period ranging from 12 to 156 months. The meta-analysis revealed that patients whose post-diagnosis rPA was ≥ 7.5 metabolic equivalents (MET-h/week) had a lower BC risk than patients whose rPA was 0-3 MET-h/week (hazard ratio [HR], 0.65; 95% CI, 0.58-0.73, p < 0.00001, I = 0%). The review indicated that a post-diagnosis rPA of ≥ 7.5 MET-h/week could reduce the risk of BC recurrence by 35%. Although it is necessary to investigate randomized controlled studies in the future, this result will strengthen strategies for the care and/or treatment of patients after BC and can motivate BC survivors to participate in rPA programs after BC diagnosis.
目的:乳腺癌(BC)的复发显著降低了 5 年生存率,这导致大多数 BC 幸存者对 BC 复发感到恐惧。由于纳入的研究数量较少,以及研究之间存在方法学异质性,目前关于诊断后休闲体力活动(rPA)是否可以预防 BC 复发的证据尚不一致。本系统评价旨在通过对现有的研究进行荟萃分析来控制 rPA 的分类,从而阐明诊断后 rPA 与 BC 复发风险之间的关系。
发现:检索了前瞻性队列研究,有五项研究符合荟萃分析的条件。在 10094 名 BC 患者中,有 1561 人在 12 至 156 个月的随访期间复发。荟萃分析显示,诊断后 rPA≥7.5 代谢当量(MET-h/周)的患者与 rPA 为 0-3 MET-h/周的患者相比,BC 风险更低(风险比[HR],0.65;95%置信区间,0.58-0.73,p<0.00001,I=0%)。该综述表明,诊断后 rPA≥7.5 MET-h/周可使 BC 复发风险降低 35%。尽管未来有必要进行随机对照研究,但这一结果将加强 BC 患者护理和/或治疗策略,并激励 BC 幸存者在 BC 诊断后参与 rPA 计划。