Effects of a home-based exercise program on the insulin-like growth factor axis in patients operated for colorectal cancer in Sweden: Results from the randomised controlled trial PHYSSURG-C

Aron Onerup; Sven-Egron Thörn; Eva Angenete; David Bock; Elin Grybäck Gillheimer; Eva Haglind; Hanna Nilsson

doi:10.1016/j.ghir.2020.01.005

Effects of a home-based exercise program on the insulin-like growth factor axis in patients operated for colorectal cancer in Sweden: Results from the randomised controlled trial PHYSSURG-C

Growth Horm IGF Res. 2020 Apr;51:27-33. doi: 10.1016/j.ghir.2020.01.005. Epub 2020 Jan 28.

Authors

Aron Onerup¹, Sven-Egron Thörn², Eva Angenete³, David Bock⁴, Elin Grybäck Gillheimer⁴, Eva Haglind³, Hanna Nilsson³

Affiliations

¹ Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Scandinavian Surgical Outcomes Research Group (SSORG), Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Pediatric Oncology, Gothenburg, Sweden. Electronic address: aron.onerup@gu.se.
² Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Anaesthesiology and Intensive Care Medicine, Gothenburg, Sweden.
³ Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Scandinavian Surgical Outcomes Research Group (SSORG), Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden.
⁴ Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Scandinavian Surgical Outcomes Research Group (SSORG), Gothenburg, Sweden.

PMID: 32007834
DOI: 10.1016/j.ghir.2020.01.005

Abstract

Objectives: We report results from a subgroup within the ongoing PHYSSURG-C trial with the aim to examine effects of exercise on IGF-1 and IGFBP-3 in patients undergoing colorectal cancer surgery.

Design: Randomised controlled trial.

Setting: A Swedish university hospital.

Participants: Between 2015 and 2016, 217 patients were enrolled (I = 106, C = 111), with 122 patients that had given blood samples at baseline and at least at one follow-up (I = 51, C = 71). Patients 20 year or older with colorectal cancer were eligible. Exclusion criteria were emergency surgery, local surgery, language problems or inability to perform intervention.

Interventions: Patients were computer-randomised to either a daily home-based aerobic exercise intervention (I), or to usual care (C). The intervention lasted two weeks before surgery and four weeks after discharge from hospital and consisted of medium-intensity aerobic exercise and inspiratory muscle training. Circulating concentrations of IGF-1 and IGFBP-3 were determined by blinded personnel at baseline, time of surgery and 4-6 weeks postoperatively.

Primary and secondary outcome measures: The outcome of this subpopulation report was change in IGF-1/IGFBP-3 ratio, IGF-1 and IGFBP-3 concentrations from baseline to surgery, and 4-6 weeks postoperatively.

Results: The IGF-1/IGFBP-3 ratio increased from baseline to surgery by 11% in I and 8% in C with no difference between groups (I vs. C: 1.04, 95%CI: 0.97-1.11; p = 1.000). Postoperative change was 5% in I and 3% in C with no difference between groups (I vs. C:1.03, 95%CI: 0.96-1.10; p = 1.000). Results concerning IGF-1 and IGFBP-3 also showed statistically significant dynamics over time with no difference between groups. No adverse events were reported.

Conclusions: The home-based exercise program in our trial did not have any effect on IGF-1, or IGFBP-3.

Trial registration: The study was registered at ClinicalTrials.gov with identifier NCT02299596. This work was funded externally.

Keywords: Colorectal neoplasms; Colorectal surgery; Exercise; Insulin-like growth factor I; Insulin-like growth factor binding protein 3.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Breathing Exercises / methods*
Colorectal Neoplasms / metabolism
Colorectal Neoplasms / surgery*
Exercise Therapy / methods*
Female
Glycated Hemoglobin / metabolism*
Humans
Insulin-Like Growth Factor Binding Protein 3 / metabolism*
Insulin-Like Growth Factor I / metabolism*
Male
Middle Aged
Postoperative Care / methods
Preoperative Care
Preoperative Exercise*
Sweden

Substances

Glycated Hemoglobin A
IGF1 protein, human
IGFBP3 protein, human
Insulin-Like Growth Factor Binding Protein 3
hemoglobin A1c protein, human
Insulin-Like Growth Factor I

Associated data

ClinicalTrials.gov/NCT02299596