Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jun 3.
doi: 10.1007/s11547-025-02016-9. Online ahead of print.

The impact of sarcopenia on sarcoma patients: a systematic review and meta-analysis

Domenico Albano  1   2 , Moreno Zanardo  3 , Mariachiara Basile  4 , Nicole Alessandra De Micheli  4 , Alessandro Berenghi  4 , Francesca Serpi  1 , Salvatore Gitto  1   5 , Carmelo Messina  5   6 , Luca Maria Sconfienza  1   5
Affiliations
Free article
Review

The impact of sarcopenia on sarcoma patients: a systematic review and meta-analysis

Domenico Albano et al. Radiol Med. .
Free article

Abstract

Purpose: Sarcopenia has been linked to poor outcomes in various cancers, but its specific effect on sarcoma patients remains unclear. This systematic review and meta-analysis investigates the impact of sarcopenia, estimated using CT, on sarcoma patients, focusing on prognostic implications and associated outcomes.

Materials and methods: The PubMed, Embase, and SCOPUS databases were searched up to March 2025. Then, a meta-analysis of the data was performed. Overall survival (OS) and relapse-free survival (RFS) were the endpoints. Hazard ratios and 95% confidence intervals were assessed to evaluate the association between sarcopenia and survival of sarcoma patients.

Results: Eighteen studies with a total of 1699 patients met the inclusion criteria. Liposarcoma was the most reported histotype in 67% of the studies, with extremities being the most common tumor location (50%), and chemotherapy was the primary intervention in 89% of cases, followed by radiation therapy (78%) and surgery (67%). Analyzing seven articles, a pooled HR of 1.91 (95% CI 1.09-3.34) for OS was reached, indicating that sarcopenic patients have a 91% higher risk of mortality compared to non-sarcopenic patients (p < 0.01). There is no evidence of selective publication (p = 0.137). The meta-analysis for the two studies that reported HR of RFS resulted 1.16 (95% CI 0.85-1.59), not significant (p = 0.28). The quality of the included studies demonstrated high methodological rigor.

Conclusions: Worse outcomes have been observed in sarcopenic patients with sarcomas, but the impact of sarcopenia on OS and RFS still remains uncertain, highlighting the need for further research and standardized approaches. Trial Registration The protocol for this review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (registration unique identifying number: CRD42024578969).

Keywords: Meta-analysis; Mortality; Sarcoma; Sarcopenia; Survival; Systematic review.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: All authors declare that they have no conflict of interest related to this study. Ethical approval: The manuscript does not contain clinical studies or patient data. This study is a systematic review of previously published data. Therefore, ethical approval was not required.

Similar articles

See all similar articles

References

    1. Cruz-Jentoft AJ et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31. https://doi.org/10.1093/ageing/afy169 - DOI - PubMed
    1. Sayer AA, Syddall H, Martin H, Patel H, Baylis D, Cooper C (2008) The developmental origins of sarcopenia. J Nutr Health Aging 12:427–432. https://doi.org/10.1007/BF02982703 - DOI - PubMed - PMC
    1. Lin W, Nguyen T, Huang W, Guo H, Wu L (2024) Sarcopenia and survival in colorectal cancer without distant metastasis: a systematic review and meta-analysis. J Gastroenterol Hepatol. https://doi.org/10.1111/jgh.16681 - DOI - PubMed - PMC
    1. Giakoustidis A, Papakonstantinou M, Chatzikomnitsa P, Gkaitatzi AD, Bangeas P, Loufopoulos PD, Louri E, Myriskou A, Moschos I, Antoniadis D, Giakoustidis D, Papadopoulos VN (2024) The effects of sarcopenia on overall survival and postoperative complications of patients undergoing hepatic resection for primary or metastatic liver cancer: a systematic review and meta-analysis. J Clin Med 13:3869. https://doi.org/10.3390/jcm13133869 - DOI - PubMed - PMC
    1. Su Q, Shen J (2024) Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: a meta-analysis. PLoS ONE 19:e0303494. https://doi.org/10.1371/journal.pone.0303494 - DOI - PubMed - PMC