Lung cancer is associated with numerous metabolic abnormalities that can cause changes in body composition and neuromuscular capacity. Sarcopenia refers to the progressive loss of strength, muscle mass, and performance, being an independent predictor of poor prognosis in patients with lung cancer, in addition to being considered a risk factor for increased chemotoxicity.

To evaluate the effect of sarcopenia on survival, length of hospital stays and functional capacity of patients with lung cancer.

This is a systematic review developed according to the Cochrane manual for systematic reviews with the following eligibility criteria: (P) patients with lung cancer; (E) sarcopenia; (C) absence of sarcopenia; and (O) survival, length of hospital stay and functional capacity. Searches were conducted in the databases: CINAHL, Cochrane Library, EMBASE, IBECS, LILACS, Livivo, PEDro, PubMed/MEDLINE, SciELO, Scopus and Web of Science. Study screening was performed on the Rayyan platform by two independent reviewers. Potentially eligible studies were read in full for final decision. Disagreements were resolved in consultation with the senior reviewer. Methodological quality was observed using a Newcastle Ottawa scale for cohort studies. Data were organized and analyzed in an electronic spreadsheet. The research protocol is registered in the PROSPERO database (CRD42022355782).

The initial search retrieved 3,542 titles. The final selection resulted in 14 studies included for the qualitative synthesis. The included studies are observational, predominantly with a retrospective cohort design, and have good methodological quality (7 to 8 points). The final sample consisted of 4,062 patients with lung cancer (age 66.3 ± 5.4 years), of which: 1,343 were sarcopenic and 2,719 were non-sarcopenic. The survival rate of patients with lung cancer and sarcopenia was lower than that of patients with lung cancer and non-sarcopenia after 5 years of follow-up (19.4% vs 28.9%, p < 0.001). Functional performance, assessed by the distance covered in the six-minute walk test, was lower in the sarcopenic group compared to the non-sarcopenic group (516 ± 75m vs 526 ± 74m, p < 0.001). There was no difference in length of stay (11 vs 11 days, p = 1.000).

Sarcopenia reduces survival in patients with lung cancer and results in lower functional capacity, with no influence on the length of hospital stay.

We emphasize the importance of synthesizing information about the effect of sarcopenia associated with lung cancer to contribute to the clinical decision-making of professionals who work in this health condition and population, helping professionals to base their interventions on evidence.