Changes of bone, adipose, and muscle-related body compositions in gastric cancers after gastrectomy using deep learning based automatic segmentation.

All body composition parameters including bone mineral density, adipose tissue, and muscle decreased significantly 12 months after gastrectomy.

• Study included 146 gastric cancer patients who underwent gastrectomy
• All p < 0.001 for changes in body composition parameters at baseline versus 12 months post-surgery
• Body compositions were automatically measured using an AI-based deep learning segmentation tool
• This was a retrospective study design

The greatest losses in body composition after gastrectomy were observed in adipose-related compositions.

• Both subcutaneous and visceral adipose tissues showed significant decreases
• Adipose-related losses were larger in magnitude than bone or muscle losses
• Adipose- and muscle-related losses differed significantly in patients who underwent different types of gastrectomy (all FDR p < 0.05)
• BMD loss showed no significant difference across gastrectomy types

The proportion of patients with sarcopenia increased significantly from 37.7% to 55.5% over 12 months after gastrectomy.

• Baseline sarcopenia prevalence was 37.7% among the 146 gastric cancer patients
• At 12 months post-surgery, sarcopenia prevalence rose to 55.5%
• This represents an increase of approximately 17.8 percentage points
• Abdominal wall muscle and skeletal muscle losses showed significant differences by gender and BMI subgroups (all FDR p < 0.05)

The proportion of patients with osteoporosis increased significantly from 13.7% to 26.7% over 12 months after gastrectomy.

• Baseline osteoporosis prevalence was 13.7% among the 146 gastric cancer patients
• At 12 months post-surgery, osteoporosis prevalence rose to 26.7%
• This represents an approximately doubling of osteoporosis prevalence
• Bone mineral density loss showed no significant difference across gender, BMI, or gastrectomy type subgroups

Gender and baseline BMI significantly affected adipose- and muscle-related body composition losses after gastrectomy.

• Subcutaneous and visceral adipose tissues, abdominal wall muscle, and skeletal muscle losses indicated significant differences in gender and BMI subgroups (all FDR p < 0.05)
• Benjamini-Hochberg false discovery rate (FDR) correction was applied for all subgroup analyses
• Gender, baseline BMI, and gastrectomy type differences showed no significant effect on BMD loss
• Subgroup analyses based on pathological stages showed no significant difference for any body composition changes

Type of gastrectomy significantly affected adipose- and muscle-related body composition losses but not bone mineral density loss.

• Adipose- and muscle-related losses differed significantly in gastric cancer patients who underwent different types of gastrectomy (all FDR p < 0.05)
• BMD loss showed no significant difference across gastrectomy types
• FDR correction using Benjamini-Hochberg method was applied to account for multiple comparisons in subgroup analyses