Work

Prognostic role of sarcopenia in anal squamous cell carcinoma treated with chemoradiotherapy: systematic review and meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background: Sarcopenia is a recognised prognostic factor in cancer patients treated with definitive radiotherapy, but its relevance in anal squamous cell carcinoma (ASCC) is poorly defined. We aimed to evaluate the prevalence of sarcopenia in ASCC and its association with treatment-related toxicity and survival outcomes in patients with ASCC treated with chemoradiotherapy. Materials and methods: A systematic review and meta-analysis were performed to determine the effect of sarcopenia, defined by skeletal muscle index (SMI), on overall survival (OS) in patients with ASCC treated with chemoradiotherapy. Hazard ratios (HRs) for OS and disease-free survival (DFS) were pooled using an inverse variance random-effects model. Prevalence was estimated using random-effects meta-analysis of proportions with Freeman-Tukey double arcsine transformation. Toxicity outcomes were synthesised qualitatively due to heterogeneity in outcome definitions and reporting. Results: = 0%). No significant association was found for DFS. Qualitative synthesis indicated that sarcopenia was linked to severe haematological toxicity and to chemotherapy modifications, while no study demonstrated an effect on radiotherapy delivery. Conclusions: Sarcopenia affects approximately one-third of ASCC patients and is associated with a nearly threefold increased risk of death. Sarcopenia is linked to haematological toxicity and chemotherapy modifications, but not to radiotherapy interruptions. Prospective studies with standardised definitions and functional assessments are needed to clarify its prognostic role in ASCC treated with chemoradiotherapy.

Source: Reports of Practical Oncology & Radiotherapy

DOI: 10.5603/rpor.113087