{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:11:18Z","timestamp":1777439478176,"version":"3.51.4"},"reference-count":122,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Sports Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A wealth of evidence supports an association between physical exercise, decreased tumor growth rate, and reduced risk of cancer mortality. In this context, the tumor vascular microenvironment may play a key role in modulating tumor biologic behavior. The present systematic review and meta-analysis aimed to summarize the evidence regarding the effects of physical exercise on tumor vasculature in pre-clinical studies. We performed a computerized research on the PubMed, Scopus, and EBSCO databases to identify pre-clinical studies that evaluated the effect of physical exercise on tumor vascular outcomes. Mean differences were calculated through a random effects model. The present systematic review included 13 studies involving 373 animals. From these, 11 studies evaluated chronic intratumoral vascular adaptations and 2 studies assessed the acute intratumoral vascular adaptations to physical exercise. The chronic intratumoral vascular adaptations resulted in higher tumor microvessel density in 4 studies, increased tumor perfusion in 2 studies, and reduced intratumoral hypoxia in 3 studies. Quantitatively, regular physical exercise induced an increased tumor vascularization of 2.13 [1.07, 3.20] (p&lt;0.0001). The acute intratumoral vascular adaptations included increased vascular conductance and reduced vascular resistance, which improved tumor perfusion and attenuated intratumoral hypoxia. In pre-clinical studies, physical exercise seems to improve tumor vascularization.<\/jats:p>","DOI":"10.1055\/a-1533-1876","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:05:54Z","timestamp":1627949154000},"page":"1237-1249","source":"Crossref","is-referenced-by-count":15,"title":["The Effects of Physical Exercise on Tumor Vasculature: Systematic Review and Meta-analysis"],"prefix":"10.1055","volume":"42","author":[{"given":"M\u00e1rio","family":"Esteves","sequence":"additional","affiliation":[{"name":"Laboratory of Biochemistry and Experimental Morphology, CIAFEL, Porto, Portugal"},{"name":"Department of Physical Medicine and Rehabilitation, Teaching Hospital of the Fernando Pessoa University, Gondomar, Portugal"}]},{"given":"Mariana P.","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Universidade do Porto Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Porto, Portugal"}]},{"given":"Jose Alberto","family":"Duarte","sequence":"additional","affiliation":[{"name":"Laboratory of Biochemistry and Experimental Morphology, CIAFEL, Porto, Portugal"},{"name":"TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra, Portugal"}]}],"member":"194","published-online":{"date-parts":[[2021,8,2]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"F Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"940","DOI":"10.3389\/fimmu.2020.00940","article-title":"The tumor microenvironment: a milieu hindering and obstructing antitumor immune responses","volume":"11","author":"A Labani-Motlagh","year":"2020","journal-title":"Front Immunol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1055\/a-1308-3476","article-title":"Role of regular physical exercise in tumor vasculature: favorable modulator of tumor milieu","volume":"42","author":"M Esteves","year":"2021","journal-title":"Int J Sports Med"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s12943-019-1089-9","article-title":"Role of hypoxia in cancer therapy by regulating the tumor microenvironment","volume":"18","author":"X Jing","year":"2019","journal-title":"Mol Cancer"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1038\/s41389-017-0011-9","article-title":"The hypoxic tumour microenvironment","volume":"7","author":"V Petrova","year":"2018","journal-title":"Oncogenesis"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.pharmthera.2015.06.006","article-title":"Modulation of the tumor vasculature and oxygenation to improve therapy","volume":"153","author":"D W Siemann","year":"2015","journal-title":"Pharmacol Ther"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"5259","DOI":"10.7150\/thno.29098","article-title":"Chemoresistance of cancer cells: Requirements of tumor microenvironment-mimicking in vitro models in anti-cancer drug development","volume":"8","author":"Y Jo","year":"2018","journal-title":"Theranostics"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"C569","DOI":"10.1152\/ajpcell.00207.2015","article-title":"Hypoxia: A key player in antitumor immune response. 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