PRETREATMENT sarcopenia and muscle loss during treatment are strongly associated with poorer overall survival and disease progression in patients with cervical cancer, emphasising the need for routine muscle assessment in clinical practice.
Sarcopenia, a condition characterised by inadequate muscle mass and function, is frequently associated with ageing and cancer. It is increasingly recognised as a factor influencing clinical outcomes in oncology, particularly in cervical cancer. A recent systematic review and meta-analysis investigated the impact of sarcopenia at pretreatment and muscle changes during treatment on survival and disease progression in cervical cancer patients. By synthesising data from multiple studies, the analysis aimed to highlight the prognostic significance of muscle health and its potential role in guiding treatment strategies.
The study analysed data from 11 studies on pretreatment sarcopenia (1,907 patients) and 7 studies on muscle changes during treatment (1,016 patients). None of the included studies assessed muscle strength or function. Meta-analysis of univariate data revealed that pretreatment sarcopenia significantly increased the risk of poor overall survival (hazard ratio [HR], 1.58; 95% CI, 1.16–2.14; p = 0.003) and progression-free survival (HR, 1.63; 95% CI, 1.16–2.29; p = 0.005). Multivariate analysis strengthened these findings, showing a more pronounced association with poor overall survival (HR, 3.09; 95% CI, 2.07–4.61; p < 0.00001) and progression-free survival (HR, 1.55; 95% CI, 1.06–2.28; p = 0.03). Muscle loss during treatment was associated with a significantly increased risk of poor overall survival (HR, 5.18; 95% CI, 3.54–7.56; p < 0.00001) and progression-free survival (HR, 2.62; 95% CI, 1.63–4.22; p < 0.00001). Subgroup analyses highlighted that the association between sarcopenia and outcomes was influenced by measurement techniques and cut-off values for muscle mass, while muscle loss consistently predicted worse outcomes.
These findings highlight the critical role of muscle health in cervical cancer prognosis. The authors suggest routine assessment and monitoring of muscle mass should be integrated into clinical practice to identify at-risk patients early and guide interventions aimed at preserving muscle health. Additionally, future research should explore the inclusion of muscle function and strength measurements to develop more comprehensive prognostic tools.
Abigail Craig, EMJ
Reference
Wang F t al. The prognostic value of sarcopenia in clinical outcomes in cervical cancer: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2025;16(1):e13674.
