Front Nutr. 2026 Jul 16;13:1831634. doi: 10.3389/fnut.2026.1831634. eCollection 2026.
ABSTRACT
INTRODUCTION: The role of sarcopenia in cancer treatment remains to be fully documented. This umbrella meta-analysis aimed to investigate the impact of sarcopenia on therapeutic outcomes across common malignancies with high incidence or mortality.
METHODS: We conducted an umbrella review of existing meta-analyses based on cohort studies. PubMed, Web of Science, and Embase were systematically searched from inception to October 2025. The primary endpoints were survival outcomes after surgical or first-line treatments. Supplementary meta-analyses were performed for outcomes with insufficient existing evidence. The systematic review protocol was registered in PROSPERO (CRD42022383726).
RESULTS: A total of 59 meta-analyses were included, comprising 49 from the literature search and 10 newly conducted in this study, covering 12 cancer types. 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), as well as 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 remained an independent risk factor for 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). The methodological quality of included meta-analyses was generally high, while the GRADE certainty of evidence for most outcomes was rated as low or very low. Sarcopenia was also associated with inferior survival after cancer immunotherapy.
DISCUSSION: Sarcopenia is consistently associated with adverse therapeutic outcomes across multiple cancers and treatment modalities. It warrants attention in clinical management and represents a promising target for improving cancer therapeutic outcomes.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42022383726.
PMID:42534612 | PMC:PMC13421404 | DOI:10.3389/fnut.2026.1831634
