Advances in pathogenesis and nutritional intervention of sarcopenia in esophageal cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HU Zhicheng ^1,2 , YANG Yue ^1,2 , ZHANG Siyuan ² , GOU Yunjiu ² ,  LI Yongshun ^1,2

1. First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China;
2. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China;

Corresponding?author：

LI Yongshun, Email: liyongshun.ok@163.com

Keywords：

Sarcopenia; esophageal cancer; pathogenesis; nutritional intervention; perioperative management; prehabilitation

DOI：

10.7507/1007-4848.202606014

Video：

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Abstract Full text Figures/Tables Video References Cited by

Sarcopenia is a syndrome characterized by progressive decline in skeletal muscle mass, strength, and function, with a high prevalence in patients with esophageal cancer. Due to tumor consumption, feeding difficulties, systemic inflammatory response, and treatment-related toxicities, patients with esophageal cancer are particularly susceptible to sarcopenia. Numerous studies have demonstrated that sarcopenia is closely associated with increased postoperative complications, prolonged hospital stay, decreased quality of life, and reduced overall survival in esophageal cancer patients. The pathogenesis of sarcopenia involves multifaceted interactions, including tumor-related inflammatory cytokine release, mitochondrial dysfunction, imbalance between protein synthesis and degradation, neuromuscular junction dysfunction, and inadequate nutritional intake. In recent years, nutritional intervention has garnered widespread attention as an important strategy for sarcopenia prevention and treatment. Preoperative nutritional risk assessment, perioperative individualized nutritional support, supplementation with specific immunonutrients, and multidisciplinary collaborative management models centered on prehabilitation have shown positive effects in improving nutritional status and mitigating muscle loss in esophageal cancer patients. This review summarizes the research progress on the epidemiological characteristics, pathogenesis, and nutritional intervention strategies of sarcopenia in esophageal cancer patients, aiming to provide reference for the identification, assessment, and management of sarcopenia in clinical practice.

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2. Chen LK, Hsiao FY, Akishita M, et al. A focus shift from sarcopenia to muscle health in the Asian Working Group for Sarcopenia 2025 Consensus Update[J]. Nat Aging, 2025, 5(11): 2164-2175.
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4. Huo Z, Luo S, Chong F, et al. Global Leadership Initiative in Sarcopenia (GLIS)-defined sarcopenia increases the mortality of esophageal cancer patients after esophagectomy: a Chinese real-world cohort study[J/OL]. Nutrition, 2025, 129: 112600. DOI: 10.1016/j.nut.2024.112600.
5. Huang YL, Wu CC, Chou IT, et al. Body components at T12/L3 on CT and correlation with survival in esophageal cancer[J]. Eur Radiol, 2026, 36(2): 1493-1505.
6. Li S, Xie K, Xiao X, et al. Correlation between sarcopenia and esophageal cancer: a narrative review[J/OL]. World J Surg Oncol, 2024, 22(1): 27. DOI: 10.1186/s12957-024-03304-w.
7. Jogiat UM, Bédard A, Baracos V, et al. Thoracic muscle mass predicts survival among patients with locally advanced esophageal cancer[J]. Clin Nutr, 2025, 49: 90-97.
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