Sarcopenia, a progressive and generalized skeletal muscle disorder, poses a major clinical concern in oncology. It can lead to reduced treatment tolerance, higher toxicity, longer hospital stays, and poorer survival. Although the overall prevalence of sarcopenia in solid tumors is often reported at around one-third of patients, substantial variability exists across regions. This variability may stem from demographic factors (e.g., age and body habitus), lifestyle (diet, physical activity), and different healthcare practices. Additionally, heterogeneous cutoff thresholds for “low skeletal muscle mass” (LSMM) on imaging pose challenges to direct comparisons.
Computed tomography (CT) is widely accepted as a reliable tool to quantify skeletal muscle. Measuring cross-sectional muscle area at the third lumbar vertebra (L3) to obtain a skeletal muscle index (SMI) is a common approach. Nonetheless, these SMI-based cutoffs differ from study to study. Despite the growing number of investigations, no meta-analysis has systematically compared sarcopenia prevalence in solid tumors across several world regions (Europe, North America, and Asia), while focusing on the potential influence of curative versus palliative treatment.
Here, we present the first large-scale systematic review and meta-analysis limited to CT-based evaluations of sarcopenia in adult oncology patients. Our goals were to:
- Quantify the overall prevalence of sarcopenia in patients with solid malignancies.
- Compare region-specific estimates of sarcopenia prevalence in Europe, North America, and Asia.
- Assess differences between curative and palliative treatment settings.
Findings may inform region-adapted care strategies and reinforce the importance of standardized diagnostic criteria.