The role of preoperative sarcopenia in post-nephrectomy prognosis of renal cell carcinoma: an integrated systematic review and meta-analysis.

Abstract

<h4>Background</h4>Although several studies have suggested that sarcopenia is associated with adverse outcomes in kidney cancer patients undergoing nephrectomy, the results have been inconsistent. Therefore, this meta-analysis was conducted to investigate the relationship between sarcopenia and post-nephrectomy survival in kidney cancer patients.<h4>Methods</h4>A thorough search was executed across multiple databases, including MEDLINE, Embase, and the Cochrane Library, to identify pertinent studies up to August, 2025. By employing random/fixed effects models, we calculated multivariate-adjusted hazard ratios (HRs) accompanied by their respective 95% confidence intervals (CIs), in strict compliance with the guidelines delineated in the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement.<h4>Results</h4>A total of thirteen studies encompassing 3,142 patients who underwent nephrectomy fulfilled the inclusion criteria. Regarding the thirteen aggregated multivariate estimates, sarcopenia was found to be associated with reduced OS (HR = 1.63, 95% CI: 1.25-2.01) and CSS (HR = 1.93, 95% CI: 1.40-2.45). Nevertheless, our findings suggest that sarcopenia is not correlated with inferior PFS in kidney cancer patients post-nephrectomy (HR = 1.17; 95% CI: 0.92-1.41). The robustness of these findings is substantiated by sensitivity and meta-regression analyses.<h4>Conclusions</h4>Sarcopenia has been demonstrated to be independently correlated with inferior OS and CSS in individuals who have undergone nephrectomy for kidney carcinoma. These empirical observations highlight the critical necessity of sarcopenia evaluation in the context of risk stratification, patient advisement, and therapeutic strategy formulation.