Temporal muscle thickness and the survival of patients with IDH-wildtype glioblastoma: a meta-analysis
Abstract
Temporal muscle thickness (TMT), an imaging-based surrogate of skeletal muscle mass and sarcopenia, has emerged as a potential prognostic marker in glioblastoma. However, its prognostic value in patients with isocitrate dehydrogenase wild-type (IDH-wt) glioblastoma remains uncertain. This meta-analysis evaluated the association between baseline TMT and survival outcomes in this population. PubMed, Embase, and Web of Science were searched from inception to June 9, 2026. Cohort studies evaluating baseline TMT in relation to overall survival (OS) and/or progression-free survival (PFS) in patients with newly diagnosed IDH-wt glioblastoma were included. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using random-effects models accounting for the influence of potential heterogeneity. Twelve retrospective cohort studies involving 2,762 patients were included. Low baseline TMT was significantly associated with poorer OS (12 studies; HR, 1.81; 95% CI: 1.38 to 2.37; p < 0.001; I² = 81%) and PFS (4 studies; HR, 1.65; 95% CI: 1.37 to 1.99; p < 0.001; I² = 15%). The association with poorer OS remained significant across subgroups defined by geographic region, mean age, TMT cutoff method and value, follow-up duration, analytic model, MGMT methylation adjustment, and study quality, with no significant between-subgroup differences. Meta-regression identified mean age as a significant moderator (coefficient, −0.064; 95% CI, −0.122 to −0.006; p =0.03) for the association between low TMT and poor OS. Low baseline TMT is associated with poorer OS and PFS in patients with newly diagnosed IDH-wt glioblastoma, although substantial between-study heterogeneity for OS warrants cautious interpretation. TMT may serve as a complementary prognostic marker, but further prospective studies are needed to establish its independent prognostic and clinical utility. https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420261455834.