The Prevalence and Prognostic Impact of Cancer Cachexia on Overall Survival in Patients with Gastrointestinal Cancer: A Meta-Analysis

Cancer cachexia is a multifactorial syndrome characterized by progressive weight loss, predominantly due to the depletion of skeletal muscle mass and adipose tissue. This meta-analysis aimed to evaluate the prognostic impact of cancer cachexia on overall survival in patients with gastrointestinal cancers. Two independent investigators conducted a systematic literature search across PubMed, Embase, and Web of Science. Eligible studies included cohort studies and post hoc analyses of clinical trials that examined the association between cancer cachexia and overall survival in gastrointestinal cancer patients. A total of 22 studies involving 10,480 patients were included in the analysis. The pooled prevalence of cachexia among gastrointestinal cancer patients was 50% (95% confidence interval [CI] 41-59). Meta-analysis demonstrated that cancer cachexia was significantly associated with reduced overall survival (hazard ratio [HR] 1.50; 95% CI 1.35-1.68). Subgroup analyses further confirmed that cancer cachexia remained a robust predictor of poorer survival, irrespective of study design, gastrointestinal cancer subtype, patients' age, country of origin, tumor stage, cachexia definition, or follow-up duration. These findings indicate that cancer cachexia is highly prevalent among gastrointestinal cancer patients and serves as a significant independent predictor of shortened overall survival.