Highlighting sarcopenia management in cancer treatments: evidence from umbrella meta-analysis.
Level 3 - non-randomized controlled study
Umbrella review and meta-analysis of observational cohort studies
PubMed 42534612 · doi:10.3389/fnut.2026.1831634
What was done
An umbrella review and supplementary meta-analyses were conducted across PubMed, Web of Science, and Embase from inception to October 2025 (PROSPERO CRD42022383726). The authors included 59 meta-analyses (49 from literature, 10 newly conducted) based on cohort studies covering 12 cancer types to evaluate the impact of sarcopenia on survival outcomes and complications following surgical or first-line non-surgical treatments.
What was found
In patients undergoing surgery, sarcopenia was significantly associated with shorter overall survival (HR = 1.59, 95% CI: 1.37–1.88) and disease-free survival (HR = 1.64, 95% CI: 1.39–1.93), alongside increased risks of any postoperative complications (OR = 1.48, 95% CI: 1.21–1.81) and major complications (OR = 1.51, 95% CI: 1.30–1.76). In patients receiving first-line non-surgical therapy, sarcopenia was associated with poorer overall survival (HR = 1.49, 95% CI: 1.39–1.61) and progression-free survival (HR = 1.39, 95% CI: 1.17–1.66). Inferior survival after immunotherapy was also noted, though numerical metrics were not detailed in the abstract.
Why it matters
This review synthesizes broad evidence confirming that sarcopenia is an independent negative prognostic factor across common malignancies and treatment modalities. It highlights muscle wasting as a clinical target to consider alongside standard oncology therapies.
Limits
The primary evidence relies on observational cohort studies rather than randomized trials. The GRADE certainty for most outcomes was rated as low or very low. The abstract does not report the total participant sample size, specific diagnostic criteria or cutoffs for sarcopenia, or exact effect sizes for the immunotherapy subgroup.
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- context Low skeletal muscle mass in cancer patients is a critical driver of cancer recurrence and mortality.