High Prevalence of Sarcopenia Identified in Patients With Ovarian, Endometrial Cancer

Sarcopenia is highly prevalent among patients with gynecologic cancers, especially those with endometrial or ovarian cancer, according to a study published in Journal of Cachexia, Sarcopenia and Muscle.¹

As defined by the European Working Group on Sarcopenia, sarcopenia is a progressive and generalized skeletal muscle disorder associated with an elevated risk of physical disability, fractures, falls, mortality, and other adverse outcomes.² Patients with tumors experience heightened catabolic activity and reduced anabolic processes, leading to a higher sarcopenia prevalence than the general population.¹ The researchers emphasized that specific treatments, such as chemotherapy, can directly damage muscle tissue, exacerbating sarcopenia development.³

However, the reported prevalence of sarcopenia among patients with cancer varies widely due to inconsistencies in its definition and assessment methods.¹ In particular, sarcopenia in patients with gynecologic cancers has been gaining attention, but there is an absence of precise data on its prevalence in this population. Therefore, the researchers conducted a meta-analysis to assess the prevalence of sarcopenia in patients with gynecologic cancers and its impact on prognosis.

Sarcopenia has a high prevalence in patients with gynecologic cancers, especially those with ovarian and endometrial cancers. | Image Credit: tashatuvango - stock.adobe.com

Using relevant keywords, the researchers searched PubMed, Embase, Web of Science, and The Cochrane Library for eligible studies; references in the incorporated literature were hand-searched as a supplement. The screening process first involved a review of titles and abstracts, followed by a full-text review of potentially relevant studies. Two researchers independently conducted literature screening, information extraction, and cross-checking, with a third party assisting in cases of disagreement.

The researchers initially identified 4485 studies, which they narrowed down to 24 (23 cohort studies and 1 cross-sectional study) and that encompassed 4352 patients with gynecological tumors. Of these patients, 1600 were diagnosed with sarcopenia.

Across all studies, the prevalence of sarcopenia among patients with gynecologic cancers ranged from 9.5% to 62.7%. A random-effects model revealed the pooled prevalence of sarcopenia to be 38.8% (95% CI, 0.49-0.79; P < .001) in this population.

In the subgroup analyses, results varied based on disease diagnosis, age, body mass index (BMI), sarcopenia diagnostic criteria, and CT evaluation site. More specifically, the prevalence of sarcopenia was 23.68% in all patients with gynecologic tumors (95% CI, 0.35-0.79; P = .002), 43.63% in those with ovarian cancer (95% CI, 0.74-1.00; P = .04), 42.5% in patients with endometrial cancer (95% CI, 0.66-1.15; P < .32), and 32.23% in those with cervical cancer (95% CI, 0.32-1.30; P = .22).

The researchers also reported that the occurrence of sarcopenia was more frequent in patients older than 60 years and those with a BMI greater than 25 kg/m². Additionally, sarcopenia was more prevalent in patients diagnosed using the psoas muscle index and those whose CT scans assessed the L4 vertebra.

Lastly, most analyzed studies reported that overall survival was significantly lower in patients with gynecologic tumors and sarcopenia than in those with gynecologic tumors alone. However, across all studies, the researchers did not observe significant differences in progression-free survival, mortality, or length of hospital stay between the 2 groups.

They acknowledged their study's limitations, including the small number of studies analyzed and the limited sample sizes in some subgroups; this may impact the reliability of their findings. Despite these limitations, the researchers expressed confidence in their findings, using them to make recommendations for clinicians.

“Health care professionals should enhance screening for sarcopenia, identify high-risk patients early, and implement appropriate prevention measures,” the authors concluded.

References

1. Jiang C, Chen Q, Yu D, Zhou Q, Tang C, Qiao C. Prevalence and prognostic significance of sarcopenia in gynecologic oncology: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2025;16(1):e13699. doi:10.1002/jcsm.13699

2. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169

3. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603-605. doi:10.1007/s10654-010-9491-z