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.
