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Meta-Analysis
. 2020 Jan-Dec:19:1534735420917462.
doi: 10.1177/1534735420917462.

Effect of Exercise on Mortality and Recurrence in Patients With Cancer: A Systematic Review and Meta-Analysis

Shinichiro Morishita  1 , Yohei Hamaue  1 , Takuya Fukushima  2 , Takashi Tanaka  3 , Jack B Fu  4 , Jiro Nakano  5
Affiliations
Meta-Analysis

Effect of Exercise on Mortality and Recurrence in Patients With Cancer: A Systematic Review and Meta-Analysis

Shinichiro Morishita et al. Integr Cancer Ther. 2020 Jan-Dec.

Abstract

Purpose: Exercise could lower the risk of cancer recurrence and improve mortality, exercise capacity, physical and cardiovascular function, strength, and quality of life in patients with cancer. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to determine the effects of exercise on mortality and recurrence in patients with cancer. Methods: We searched for articles published before May 2019 in MEDLINE, CINAHL, the Cochrane Library, Scopus, ProQuest, and PEDro. We included RCTs of exercise interventions, such as resistance exercise and aerobic exercise, in patients with cancer that evaluated the risk of mortality and recurrence. The standardized mean difference with 95% confidence intervals (CIs) was calculated for quantitative indices. The random-effect model was used as the pooling method. Results: Of 2868 retrieved articles, 8 RCTs were included in the meta-analysis, with a mean PEDro score of 4.50 (SD = 1.25). Exercise significantly reduced the risk of mortality in patients with cancer and in cancer survivors (risk ratio [RR] = 0.76, 95% CI = 0.40-0.93, I2 = 0%, P = .009). Exercise significantly reduced the risk of recurrence in cancer survivors (RR = 0.52, 95% CI = 0.29-0.92, I2 = 25%, P = .030). Conclusion: This study found that exercise has a favorable effect on mortality and recurrence in patients with cancer. However, the effect could not be fully determined due to data insufficiency.

Keywords: cancer; exercise; mortality; recurrence; rehabilitation; survival.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study flow diagram of the selection process.
Figure 2.
Figure 2.
Risk of bias graph based on the Cochrane Collaboration’s tool for assessing risk of bias.
Figure 3.
Figure 3.
Summary of risk of bias based on the Cochrane Collaboration’s tool for assessing risk of bias.
Figure 4.
Figure 4.
Risk ratio for the effect of exercise on mortality in cancer patients and survivors.
Figure 5.
Figure 5.
Risk ratio for the effect of exercise on recurrence in cancer survivors.
See this image and copyright information in PMC

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