Beyond BMI: The Clinical Relevance of Sarcopenia and Muscle Quality in Gynecologic Oncology from Meta-Analyses to Practice—The Potential Role of Body Composition Assessment, Including BIA, in Supportive Care
6 affiliations
- 1Department of Practical Midwifery Education, Poznan University of Medical Sciences, 60-781 Poznan, Poland
- 2Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznan, Poland
- 3Doctoral School, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- 4Students’ Scientific Society, Poznan University of Medical Sciences, 60-781 Poznan, Poland
- 5Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-635 Katowice, Poland
- 6Department of Mother’s and Child’s Health, Gynecologic and Obstetrical University Hospital, Poznan University of Medical Sciences, Polna St 33, 60-535 Poznan, Poland
Abstract
Sarcopenia, low muscle mass, and low muscle radiodensity are increasingly being considered factors associated with treatment outcomes in patients with gynecological malignancies. Despite the growing body of evidence, body composition assessment is not routinely incorporated into clinical practice. The aim of this review was to present current evidence on the associations of muscle parameters with survival, complications, systemic treatment toxicity, and quality of life, as well as to discuss the opportunities and limitations of computed tomography (CT) and bioelectrical impedance analysis (BIA) in body composition monitoring. A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases, primarily covering publications from 2019 to 2026, together with earlier studies relevant to the topic. Systematic reviews, meta-analyses, and selected observational, longitudinal, and interventional studies were included. The available evidence indicates that low muscle mass and low muscle radiodensity are primarily associated with poorer overall survival and an increased risk of selected postoperative complications. Evidence regarding progression-free survival, disease recurrence, chemotherapy toxicity, and quality of life remains less consistent. Low muscle mass may occur independently of body weight and body mass index (BMI); therefore, routine anthropometric assessment may fail to identify adverse changes in body composition. CT image analysis enables quantitative assessment of muscle mass and evaluation of muscle radiodensity, whereas BIA may serve as a complementary tool for repeated body composition monitoring. However, its use is limited by the effects of hydration status, edema, and ascites, as well as by the lack of validated cut-off values for patients with gynecological malignancies. Body composition assessment should be interpreted in conjunction with evaluations of muscle strength, physical performance, nutritional status, treatment toxicity, and quality of life. Prospective studies are needed to determine whether body composition monitoring and the implementation of targeted supportive care improve treatment tolerance and clinical outcomes.
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BibTeX
@article{pieta2026beyond,
title = {{Beyond BMI: The Clinical Relevance of Sarcopenia and Muscle Quality in Gynecologic Oncology from Meta-Analyses to Practice—The Potential Role of Body Composition Assessment, Including BIA, in Supportive Care}},
author = {Beata Pięta and Karolina Gajewska and Małgorzata Mikołajczyk and Michalina Wiśniewska and Alicja Rzymska and Bartłomiej Burzyński and Paweł Rzymski},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193164},
url = {https://europepmc.org/article/PMC/PMC13664003},
note = {CC BY},
}
RIS
TY - JOUR
TI - Beyond BMI: The Clinical Relevance of Sarcopenia and Muscle Quality in Gynecologic Oncology from Meta-Analyses to Practice—The Potential Role of Body Composition Assessment, Including BIA, in Supportive Care
AU - Beata Pięta
AU - Karolina Gajewska
AU - Małgorzata Mikołajczyk
AU - Michalina Wiśniewska
AU - Alicja Rzymska
AU - Bartłomiej Burzyński
AU - Paweł Rzymski
PY - 2026
DA - 2026/10/01
JO - Cancers
DO - 10.3390/cancers18193164
UR - https://europepmc.org/article/PMC/PMC13664003
AB - Sarcopenia, low muscle mass, and low muscle radiodensity are increasingly being considered factors associated with treatment outcomes in patients with gynecological malignancies. Despite the growing body of evidence, body composition assessment is not routinely incorporated into clinical practice. The aim of this review was to present current evidence on the associations of muscle parameters with survival, complications, systemic treatment toxicity, and quality of life, as well as to discuss the opportunities and limitations of computed tomography (CT) and bioelectrical impedance analysis (BIA) in body composition monitoring. A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases, primarily covering publications from 2019 to 2026, together with earlier studies relevant to the topic. Systematic reviews, meta-analyses, and selected observational, longitudinal, and interventional studies were included. The available evidence indicates that low muscle mass and low muscle radiodensity are primarily associated with poorer overall survival and an increased risk of selected postoperative complications. Evidence regarding progression-free survival, disease recurrence, chemotherapy toxicity, and quality of life remains less consistent. Low muscle mass may occur independently of body weight and body mass index (BMI); therefore, routine anthropometric assessment may fail to identify adverse changes in body composition. CT image analysis enables quantitative assessment of muscle mass and evaluation of muscle radiodensity, whereas BIA may serve as a complementary tool for repeated body composition monitoring. However, its use is limited by the effects of hydration status, edema, and ascites, as well as by the lack of validated cut-off values for patients with gynecological malignancies. Body composition assessment should be interpreted in conjunction with evaluations of muscle strength, physical performance, nutritional status, treatment toxicity, and quality of life. Prospective studies are needed to determine whether body composition monitoring and the implementation of targeted supportive care improve treatment tolerance and clinical outcomes.
SN - 2072-6694
ER -