National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.
Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.
Int J Cancer. 2023 Oct 15;153(8):1512-1519. doi: 10.1002/ijc.34625. Epub 2023 Jun 19.
Physical activity (PA) has been associated with reduced mortality among cancer survivors, but no study has focused on testicular cancer survivors (TCSs). We aimed to investigate the association of PA measured twice during survivorship with overall mortality in TCSs. TCSs treated during 1980 to 1994 participated in a nationwide longitudinal survey between 1998 to 2002 (S1: n = 1392) and 2007 to 2009 (S2: n = 1011). PA was self-reported by asking for the average hours per week of leisure-time PA in the past year. Responses were converted into metabolic equivalent task hours/week (MET-h/wk) and participants were categorized into: Inactives (0 MET-h/wk), Low-Actives (2-6 MET-h/wk), Actives (10-18 MET-h/wk) and High-Actives (20-48 MET-h/wk). Mortality from S1 and S2, respectively, was analyzed using the Kaplan-Meier estimator and Cox proportional hazards models until the End of Study (December 31, 2020). Mean age at S1 was 45 years (SD 10.2). Nineteen percent (n = 268) of TCSs died between S1 and EoS, with 138 dying after S2. Compared to Inactives at S1, the mortality risk among Actives was 51% lower (HR 0.49, 95% CI: 0.29-0.84) with no further mortality reduction among High-Actives. At S2, the mortality risk was at least 60% lower among the Actives, High-Actives and even the Low-Actives compared to the Inactives. Persistent Actives (≥10 MET-h/wk at S1 and S2) had a 51% lower mortality risk compared to Persistent Inactives (<10 MET-h/wk at S1 and S2; HR 0.49, 95% CI: 0.30-0.82). During long-term survivorship after TC treatment, regular and maintained PA were associated with an overall mortality risk reduction of at least 50%.
体力活动（PA）与癌症幸存者的死亡率降低有关，但尚无研究关注睾丸癌幸存者（TCS）。我们旨在研究在生存期间两次测量的 PA 与 TCS 总死亡率之间的关系。1980 年至 1994 年接受治疗的 TCS 参加了 1998 年至 2002 年（S1：n=1392）和 2007 年至 2009 年（S2：n=1011）的全国性纵向调查。通过询问过去一年中每周平均休闲时间 PA 小时数来报告 PA。反应被转换为代谢等效任务小时/周（MET-h/wk），参与者被分为：不活动者（0 MET-h/wk）、低活动者（2-6 MET-h/wk）、活动者（10-18 MET-h/wk）和高活动者（20-48 MET-h/wk）。分别使用 Kaplan-Meier 估计器和 Cox 比例风险模型分析 S1 和 S2 的死亡率，直至研究结束（2020 年 12 月 31 日）。S1 的平均年龄为 45 岁（SD 10.2）。在 S1 和 EoS 之间，19%（n=268）的 TCS 死亡，其中 138 人在 S2 后死亡。与 S1 的不活动者相比，活动者的死亡风险降低了 51%（HR 0.49，95%CI：0.29-0.84），而高活动者的死亡率则没有进一步降低。在 S2 时，与不活动者相比，活动者、高活动者甚至低活动者的死亡率风险至少降低了 60%。与持续不活动者（S1 和 S2 时≥10 MET-h/wk）相比，持续活动者（S1 和 S2 时<10 MET-h/wk）的死亡率降低了 51%（HR 0.49，95%CI：0.30-0.82）。在 TC 治疗后的长期生存期间，定期和维持的 PA 与总体死亡率降低至少 50%相关。
