Abstract 138P
Background
Overweight, obesity and nutritional status may affect the risk of developing colorectal cancer (CRC). The aim of this retrospective study was to assess the impact of obesity, overweight and nutritional status, as measured by the Prognostic Nutritional Index (PNI), on disease- free survival, progression- free survival and overall survival in treated early and advanced CRC and to evaluate the effectiveness of artificial intelligence (AI) in conducting a retrospective study.
Methods
238 patients with CRC were retrospectively analysed, 154 with early CRC, 84 with advanced CRC. Obesity and overweight were calculated from weight and height according to the World Health Organisation’s definition. PNI was calculated as 10× albumin (g/dL) + 0.005× total lymphocyte count. The impact of obesity, overweight, PNI at cutoff of 40 and 45 on disease-free survival (DFS), progression- free survival (PFS) and overall survival (OS) were assessed. AI, specifically ChatGPT v.4 (2024), was used for data cleansing, statistical analysis (Kaplan- Meier and Cox- regression analysis) and interpretation of results.
Results
PNI ≤ 40 significantly worsened DFS (HR 2.12, p=0.0061) and OS (HR 3.11, p=0.0011) in early CRC. The results were confirmed in Cox- regression analysis with covariates such as age, nodal status, used treatment, grade and localisation of primary tumour (right colon) (PFS HR 2.27; OS HR 2.78, p- values <0.05). Surprisingly, PNI ≤ 40 did not significantly affect PFS or OS in advanced CRC. Additionally, obesity, overweight and PNI ≤ 45 did not significantly affect survival rates in early or advanced CRC. Using targeted prompts, AI effectively assisted in data cleansing and interpretation of our results directly. AI performed statistical analysis by preparing 2 dedicated scripts using Python libraries (lifelines, matplotlib). The scripts have been uploaded to public repositories for public use.
Conclusions
Severe malnutrition significantly worsened DFS and OS in early CRC but not in advanced CRC. AI substantially aided in performing a retrospective study in a regional hospital setting.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.