MIDL 2021, L8, Muhammad et. al., Full Paper
Channel: MIDL Society
Date: 08/08/2021

L8 - EPIC-Survival: End-to-end Part Inferred Clustering for Survival Analysis, with Prognostic Stratification Boosting   

Hassan Muhammad, Chensu Xie, Carlie S Sigel, Michael Doukas, Lindsay Alpert, Amber Lea Simpson, Thomas J Fuchs   

Conference page: https://2021.midl.io/papers/L8   

Abstract: Histopathology-based survival modelling has two major hurdles. Firstly, a well-performing survival model has minimal clinical application if it does not contribute to the stratification of a cancer patient cohort into different risk groups, preferably driven by histologic morphologies. In the clinical setting, individuals are not given specific prognostic predictions, but are rather predicted to lie within a risk group which has a general survival trend. Thus, It is imperative that a survival model produces well-stratified risk groups. Secondly, until now, survival modelling was done in a two-stage approach (encoding and aggregation). EPIC-Survival bridges encoding and aggregation into an end-to-end survival modelling approach, while introducing stratification boosting to encourage the model to not only optimize ranking, but also to discriminate between risk groups. In this study we show that EPIC-Survival performs better than other approaches in modelling intrahepatic cholangiocarcinoma (ICC), a historically difficult cancer to model. We found that stratification boosting further improves model performance and helps identify specific histologic differences, not commonly sought out in ICC.