What is it about?

Concurrent chemoradiotherapy for locally advanced cervical cancer (LACC) must be completed within 56 days, with each added day increasing recurrence risk by 1%. Sarcopenia, malnutrition, and cachexia affect 20–60% of patients, yet guidelines do not recommend routine screening, and their independent associations with outcomes remain unmapped

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Why is it important?

Twenty-three studies (4,352 women; cohorts 41-391) used heterogeneous definitions. Malnutrition was assessed in 17 studies, sarcopenia in 15, and cachexia in 2. Malnutrition showed 1.5- to 3.7-fold higher mortality. Chemotherapy-defined sarcopenia predicted survival in 5 of 11 assessments (HR 1.75–3.60); sarcopenic obesity carried HR 2.65. On-treatment body composition loss showed strongest effects: ≥7–10% skeletal-muscle decline (HR 6.02) and ≥15% intermuscular fat loss (HR 8.52) predicted higher mortality. Grade ≥3 toxicity and treatment interruption were 1.2- to 2.5-fold more frequent in malnourished or sarcopenic women, increasing to 3–5-fold with multiple unfavorable body-composition features. Quality-of-life scores declined 11% during treatment. Seventeen studies had high bias risk from attrition and inadequate confounder control.

Perspectives

Malnutrition, sarcopenia, and cachexia correlate with poor survival and treatment tolerance in LACC chemoradiotherapy; on-treatment muscle loss shows strongest prognostic value. Screening at baseline and muscle quantification on chemotherapy can identify high-risk patients. Consensus definitions, prospective validation, and multimodal prehabilitation trials are needed before implementation.

Dr Salvatore Cortellino
Scuola Superiore Meridionale

Read the Original

This page is a summary of: Cachexia, Sarcopenia, Malnutrition and Their Impact on Survival, Treatment Toxicities, and Quality of Life in Locally Advanced Cervical Cancer Patients Undergoing Concomitant Chemoradiotherapy: A Scoping Review, Clinical Nutrition Open Science, December 2025, Elsevier,
DOI: 10.1016/j.nutos.2025.100620.
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