Among 521 patients , high levels of physical activity before and after the diagnosis were associated with better overall survival ( the multivariate hazard ratios were 0.50 [ 95 % confidence interval = 0.26-0 .98 ] and 0.57 ( 95 % confidence interval = 0.26-1 .40 ] for patients who were very active before and after the diagnosis , respectively , in comparison with inactive patients ) .