{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:03:55Z","timestamp":1791389035287,"version":"4.3.3"},"reference-count":24,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"8","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Clin Cancer Inform"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Body composition (BC) may play a role in outcome prognostication in patients with gastroesophageal adenocarcinoma (GEAC). Artificial intelligence provides new possibilities to opportunistically quantify BC from computed tomography (CT) scans. We developed a deep learning (DL) model for fully automatic BC quantification on routine staging CTs and determined its prognostic role in a clinical cohort of patients with GEAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS<\/jats:title>\n                    <jats:p>We developed and tested a DL model to quantify BC measures defined as subcutaneous and visceral adipose tissue (VAT) and skeletal muscle on routine CT and investigated their prognostic value in a cohort of patients with GEAC using baseline, 3-6-month, and 6-12-month postoperative CTs. Primary outcome was all-cause mortality, and secondary outcome was disease-free survival (DFS). Cox regression assessed the association between (1) BC at baseline and mortality and (2) the decrease in BC between baseline and follow-up scans and mortality\/DFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Model performance was high with Dice coefficients \u22650.94 \u00b1 0.06. Among 299 patients with GEAC (age 63.0 \u00b1 10.7 years; 19.4% female), 140 deaths (47%) occurred over a median follow-up of 31.3 months. At baseline, no BC measure was associated with DFS. Only a substantial decrease in VAT &gt;70% after a 6- to 12-month follow-up was associated with mortality (hazard ratio [HR], 1.99 [95% CI, 1.18 to 3.34]; P = .009) and DFS (HR, 1.73 [95% CI, 1.01 to 2.95]; P = .045) independent of age, sex, BMI, Union for International Cancer Control stage, histologic grading, resection status, neoadjuvant therapy, and time between surgery and follow-up CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>DL enables opportunistic estimation of BC from routine staging CT to quantify prognostic information. In patients with GEAC, only a substantial decrease of VAT 6-12 months postsurgery was an independent predictor for DFS beyond traditional risk factors, which may help to identify individuals at high risk who go otherwise unnoticed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/cci.23.00231","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T15:59:46Z","timestamp":1712591986000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":7,"title":["Association Between Body Composition and Survival in Patients With Gastroesophageal Adenocarcinoma: An Automated Deep Learning Approach"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1124-4284","authenticated-orcid":true,"given":"Matthias","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2017-1857","authenticated-orcid":true,"given":"Thierno D.","family":"Diallo","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Scheef","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Reisert","sequence":"additional","affiliation":[{"name":"Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"},{"name":"Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5881-6043","authenticated-orcid":true,"given":"Alexander","family":"Rau","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3187-2429","authenticated-orcid":true,"given":"Maximilan F.","family":"Russe","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7460-3942","authenticated-orcid":true,"given":"Fabian","family":"Bamberg","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Fichtner-Feigl","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8497-582X","authenticated-orcid":true,"given":"Michael","family":"Quante","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101404"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.05.054"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-1057"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327096"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.05.060"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1016\/S1507-1367(06)71069-0"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12603"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.12934"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12379"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.22.27749"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2022.110413"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07147-3"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12062106"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-022-03695-y"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doaa121"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2021.02.008"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.2478\/raon-2020-0016"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6354-4"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.12.020"},{"key":"b20","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6683-3"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-022-00937-2"},{"key":"b22","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.11117"},{"key":"b23","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-70178-3_2"},{"key":"b24","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-019-01912-9"}],"container-title":["JCO Clinical Cancer Informatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/CCI.23.00231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T15:59:49Z","timestamp":1712591989000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/CCI.23.00231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1200\/CCI.23.00231"],"URL":"https:\/\/doi.org\/10.1200\/cci.23.00231","relation":{},"ISSN":["2473-4276"],"issn-type":[{"value":"2473-4276","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-04","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2300231"}}