Original Title: Valoración de la composición corporal y funcionalidad muscular en el paciente oncológico. Revisión sistemática

Authors' objectives: The main objective is to assess the efficacy, safety, and efficiency of using computed tomography (CT) to evaluate body composition, in combination with muscle function tests, for the early diagnosis of sarcopenia and myosteatosis in oncology patients at risk of malnutrition and frailty due to their disease and cancer treatment.

Authors' results and conclusions: Results A systematic review and nine observational studies were included, focusing on the assessment of computed tomography (CT) and functional tests in oncology patients at risk of malnutrition and frailty. No studies were identified that evaluated both tools simultaneously, which limited the integrated analysis. The included studies, mostly conducted in European and Asian settings, used diverse criteria to define sarcopenia and malnutrition, with cut-off points varying according to sex, BMI, and the technique used. This heterogeneity reflects geographical differences in applied standards, such as the Asian AWGS consensus versus European criteria, highlighting notable methodological variability among studies. CT was employed as the reference method in most studies, demonstrating higher diagnostic accuracy for estimating muscle mass and detecting sarcopenia compared to techniques such as bioelectrical impedance (BIA), ultrasound, or anthropometry. In several studies, CT showed high sensitivity, specificity, and area under the curve (AUC) values. Some studies analyzed the correlation between CT and other clinical methods, such as handgrip strength, ultrasound, or BIA, with variable results and generally low to moderate levels of agreement. The use of artificial intelligence applied to CT for automating muscle mass estimation was also identified, showing good discriminative ability. Conclusions The available evidence on the combined use of computed tomography (CT) and functional tests for the diagnosis of sarcopenia and myosteatosis in oncology patients is limited. Although CT is confirmed as the most accurate reference method for estimating muscle mass, its integration with functional tools has not yet been sufficiently evaluated. The available studies reinforce the value of CT compared with alternative methods, but they do not allow for clinical recommendations regarding its combined use. In addition, the lack of studies on safety and cost-effectiveness highlights the need for further research.

Authors' methods: A systematic review of the scientific literature was conducted following the PRISMA guidelines. The search covered studies published up to April 2025 and was performed across several databases, including Medline, Embase, Web of Science, Cochrane Library, Cinahl, and INAHTA. Additional sources were also consulted, such as websites of health technology assessment agencies (e.g., NICE, AHRQ, RedETS) and economic databases (EconLit, CEA Registry, IDEAS/RePEc). Study selection, data extraction, and quality assessment were carried out independently by two researchers. The review included systematic reviews, meta-analyses, and primary studies. Methodological quality was assessed using the AMSTAR-2 and QUADAS-2 tools.

Authors' identified further research: High-quality comparative studies are required to jointly assess the diagnostic utility of CT and functional tests in this population, in order to support their implementation in clinical practice and improve decision making in oncology patients at risk of malnutrition and frailty.

Project Status: Completed

URL for project: https://www.aetsa.org/publicacion/valoracion-de-la-composicion-corporal-y-funcionalidad-muscular-en-el-paciente-oncologico-revision-sistematica/

Year Published: 2026

URL for published report: https://www.aetsa.org/download/publicaciones/44_2024_AETSA_Valoracion-Corporal-Paciente-Oncologico_web.pdf

Requestor: Spanish Health Ministry

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

DOI: 10.52766/HXSC3525

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: <p>Andalusian Agency for Health Technology Assessment (AETSA)</p>