Deep learning-derived CT body composition enhances survival risk stratification beyond the TNM system in locally advanced gastric cancer: a multi-modality cohort study.

Deep learning-derived CTBC metrics, especially VAT/SAT ratio, enhance prognostic stratification beyond TNM staging in locally advanced gastric cancer. This ratio captures a systemic and tumor-level immunometabolic phenotype marked by mitochondrial dysfunction and immune suppression. Our findings highlight VAT/SAT as a noninvasive, clinically actionable biomarker to guide personalized therapy and risk-adapted algorithm in gastric cancer management.