Structured exercise interventions and survival outcomes in patients with cancer: systematic review and meta-analysis of randomised controlled trials
In brief
Structured exercise cuts cancer death risk by about 23%
A meta-analysis of 21 randomized trials found that patients who performed prescribed aerobic or mixed exercise had a 23% lower risk of overall mortality and a 17% lower risk of disease recurrence compared with usual care. Benefits were strongest in early-stage disease and when participants adhered well, but exercise did not improve progression-free survival, highlighting a need for further research on optimal regimens.
- Journal
- British journal of sports medicine (Q1)
- Published
- 15 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Chih-Chen Tzang, Chiao-An Luo, Vicky Fu-Hsuan Kuo, Ewen Shengyao Huang, Yuan-Fu Kang, Wen-Yu Su, et al.
- PMID
- 42744658
- DOI
- 10.1136/bjsports-2026-111664
Why clinicians should know about it
- Picked for Orthopedics and Sports Medicine (top studies of the week, 20 September 2026): Systematic review of exercise on cancer survival
- Picked for Pathology and Forensic Medicine (top studies of the week, 20 September 2026): Exercise intervention, no diagnostic pathology focus
Abstract
OBJECTIVE: Structured exercise is widely recommended in oncology care to improve quality of life and physical function, but its definitive role as a therapeutic intervention to prolong survival remains uncertain. This study aimed to quantify the association between structured exercise interventions and survival related outcomes in patients with cancer. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed, Embase, Cochrane CENTRAL, Web of Science, Scopus and ClinicalTrials.gov covering reports from database inception to 20 December 2025. ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) of structured exercise interventions in adults with confirmed cancer, reporting survival or pathological outcomes. RESULTS: 21 RCTs were included in the meta-analysis. Structured exercise was associated with significant improvements in overall survival (HR 0.77; 95% CI 0.65 to 0.92; 11 RCTs, n=3828), disease-free survival (HR 0.83; 95% CI 0.72 to 0.95; 7 RCTs, n=5077), reduced all cause mortality (RR 0.82; 95% CI 0.70 to 0.97; 13 RCTs, n=5492) and reduced cancer specific mortality (RR 0.74; 95% CI 0.57 to 0.96; 6 RCTs, n=2048), but not with progression-free survival or pathological complete response. Certainty of evidence, assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE), was rated as moderate for overall survival, disease-free survival and cancer specific and all cause mortality. Further exploratory analyses indicated a more pronounced benefit among participants with higher adherence, those who underwent aerobic exercise and those with early stage disease. CONCLUSIONS: These results support consideration of structured exercise as an effective adjuvant therapy in oncological care, with potential survival and recurrence benefits that extend beyond its traditional role in improving quality of life. TRIAL REGISTRATION: PROSPERO CRD420251245153.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.