# Association between accelerometer-measured light-intensity physical activity and tumor regression for male patients with esophageal cancer receiving neoadjuvant therapy: a retrospective cohort study

## TL;DR

This study shows that light-intensity physical activity during cancer treatment may help reduce tumor size in male esophageal cancer patients.

## Contribution

The study identifies a specific cutoff for light-intensity physical activity that correlates with tumor regression in male esophageal cancer patients undergoing neoadjuvant therapy.

## Key findings

- Each additional 30 minutes of light-intensity physical activity was linked to better tumor regression.
- A cutoff of 156.11 minutes/day of light-intensity activity was found to be optimal for tumor regression.
- Higher light-intensity activity was associated with reduced anorexia and malnutrition during treatment.

## Abstract

Physical activity has the potential to promote tumor regression in patients with esophageal cancer receiving neoadjuvant chemotherapy (NAC); however, the benefits of light-intensity physical activity (LIPA) are unclear. This study aimed to investigate the impact of LIPA on tumor regression in male patients with esophageal cancer during NAC and its optimal cutoff value.

This retrospective single-center observational study included all male patients who underwent NAC or curative esophagectomy. We assessed the physical activity of patients using an accelerometer and calculated the time spent on LIPA. Tumor regression was defined as grade ≥ 1b according to the Japanese classification of esophageal cancer. The impact of LIPA on tumor regression was analyzed using multivariate analysis, and the optimal cutoff value was identified using the receiver operating characteristic curve.

Sixty-nine male patients with esophageal cancer who underwent NAC were analyzed. The mean age was 68 years, mean body mass index was 22.4, and 80% of the patients were diagnosed with clinical stage 3 or 4 disease. Every extra 30-min increase in LIPA during the treatment phase was associated with tumor regression (adjusted OR 1.41 [1.02–2.04]). The optimal cutoff value of LIPA was 156.11 min/day, and patients with rich LIPA (≥ 156.11 min/day) were less likely to suffer from anorexia and malnutrition during NAC.

This study demonstrated that LIPA during NAC has a potential of promoting tumor regression with a cutoff value of 156.5 min/day. Further clinical research is required to determine the prognostic benefits of LIPA in patients receiving NAC.

The online version contains supplementary material available at 10.1007/s10388-025-01108-9.