Deep Learning Predicts Survival Across Squamous Tumor Entities From Routine Pathology: Insights From Head and Neck, Esophagus, Lung, and Cervical Cancer
Modern Pathology, vol. 38, pp. 100845
Abstract
Computational pathology-based models are becoming increasingly popular for extracting biomarkers from images of cancer tissue. However, their validity is often only demonstrated on a single unseen validation cohort, limiting insights into their generalizability and posing challenges for explainability. In this study, we developed models to predict overall survival using hematoxylin and eosin slides from formalin-fixed paraffin-embedded samples in head and neck squamous cell carcinoma. By validating our models across diverse squamous tumor entities, including head and neck (hazard ratio [HR], 1.58; 95% CI, 1.17-2.12; P = .003), esophageal (nonsignificant), lung (HR, 1.31; 95% CI, 1.13-1.52; P < .001), and cervical (HR, 1.39; 95% CI, 1.10-1.75; P = .005) squamous cell carcinomas, we showed that the predicted risk score captures relevant information for survival beyond head and neck squamous cell carcinoma. Correlation analysis indicated that the predicted risk score is strongly associated with various clinical factors, including human papillomavirus status, tumor volume, and smoking history, although the specific factors vary across cohorts. These results emphasize the relevance of comprehensive validation and in-depth assessment of computational pathology-based models to better characterize the underlying patterns they learn during training.
Authors 5
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Verena Bitto corresponding
Affiliation as printed
German Cancer Research Center (DKFZ), Division of Radiooncology/Radiobiology, Heidelberg, Germany. Electronic address: verena.bitto@dkfz-heidelberg.de
German Cancer Research Center (DKFZ), Division of Radiooncology / Radiobiology, Heidelberg Germany. Electronic address: verena.bitto@dkfz-heidelberg.de
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University of Electronic Science and Technology of China · Sichuan Cancer Hospital · Universitätsklinikum Aachen · Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden · RWTH Aachen University
Affiliation as printed
Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany; Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, China; Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
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German Cancer Research Center · Deutsches Konsortium für Translationale Krebsforschung
Affiliation as printed
German Cancer Research Center (DKFZ), Division of Radiooncology/Radiobiology, Heidelberg, Germany; German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany
German Cancer Research Center (DKFZ), Division of Radiooncology / Radiobiology, Heidelberg Germany; German Cancer Consortium (DKTK), core center Heidelberg, Heidelberg, Germany
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Heidelberg University · Helmholtz-Zentrum Dresden-Rossendorf · University Hospital Heidelberg · National Center for Tumor Diseases · University Hospital Carl Gustav Carus · Nationales Centrum für Tumorerkrankungen Dresden · Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden
Affiliation as printed
Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany; Medical Department I, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases Dresden (NCT/UCC), Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany; Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany; Medical Department I, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases Dresden (NCT/UCC), a partnership between DKFZ, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, and Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany; Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
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German Cancer Research Center · Deutsches Konsortium für Translationale Krebsforschung
Affiliation as printed
German Cancer Research Center (DKFZ), Division of Radiooncology/Radiobiology, Heidelberg, Germany; German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany
German Cancer Research Center (DKFZ), Division of Radiooncology / Radiobiology, Heidelberg Germany; German Cancer Consortium (DKTK), core center Heidelberg, Heidelberg, Germany
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