An international multi-centre study to develop and validate federated learning-based prognostic models for anal cancer
Nature Communications, vol. 17
Abstract
Precision oncology relies on access to high-quality data for increasingly smaller patient subgroups. The international atomCAT consortium investigates the potential of federated learning to support this, using anal cancer as a rare cancer exemplar. Here, we show that federated multivariable Cox models trained across 14 centres (1428 patients) and externally validated in two additional centres (277 patients) achieve consistent calibration and discrimination during leave-one-centre-out and external validation (c-indices 0.68-0.79). Lower T stage, absence of nodal involvement, smaller tumour volume, female sex, younger age, and mitomycin- or cisplatin-based chemotherapy are associated with improved overall survival. Lower T stage, smaller tumour volume, and female sex are associated with improved locoregional control, while absence of nodal involvement and smaller tumour volume are associated with better freedom from distant metastases. These findings demonstrate that federated learning enables robust, privacy-preserving prognostic modelling for rare cancers using real-world data, supporting international collaboration without data sharing.
Authors 69
-
Stelios Theophanous corresponding
University of Leeds · Leeds Teaching Hospitals NHS Trust
Affiliation as printed
Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK. stelios.theophanous@nhs.net
Leeds Teaching Hospitals NHS Trust, Leeds, UK. stelios.theophanous@nhs.net
-
Affiliation as printed
Department of Medical Physics, Oslo University Hospital, Oslo, Norway
-
Maastricht University Medical Centre
Affiliation as printed
Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre + , Maastricht, The Netherlands
-
Maastricht University Medical Centre
Affiliation as printed
Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre + , Maastricht, The Netherlands
-
Amsterdam UMC Location University of Amsterdam · The Netherlands Cancer Institute · Amsterdam University Medical Centers
Affiliation as printed
Department of Radiation Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands
-
Maastricht University Medical Centre
Affiliation as printed
Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre + , Maastricht, The Netherlands
-
University of Wollongong · UNSW Sydney
Affiliation as printed
Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia
Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
School of Electrical, Computer and Telecommunications Engineering, University of Wollongong, Wollongong, New South Wales, Australia
South Western Sydney Clinical Campus, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
-
Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy
-
University of Leeds · Leeds Teaching Hospitals NHS Trust
Affiliation as printed
Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
Leeds Teaching Hospitals NHS Trust, Leeds, UK
-
Oslo University Hospital · University of Oslo
Affiliation as printed
Department of Oncology, Oslo University Hospital, Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
-
Cambridge University Hospitals NHS Foundation Trust
Affiliation as printed
Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
-
The Christie NHS Foundation Trust
Affiliation as printed
The Christie NHS Foundation Trust, Manchester, UK
-
Goethe University Frankfurt · German Cancer Research Center · University Hospital Frankfurt · Frankfurt Cancer Institute · Deutsches Konsortium für Translationale Krebsforschung
Affiliation as printed
Frankfurt Cancer Institute (FCI), Frankfurt, Germany
German Cancer Research Center (DKFZ), Heidelberg, Germany, German Cancer Consortium (DKTK), Partner Site, Frankfurt, Germany
Goethe University Frankfurt, University Hospital, Department of Radiotherapy and Oncology, Frankfurt, Germany
-
Ahmed Allam Mohamed Aachen
Affiliation as printed
Center for Integrated Oncology Aachen Bonn Köln Düsseldorf (CIO ABCD), Aachen, Germany
RWTH Aachen University Medical Centre, Aachen, Germany
-
University of Oxford · Oxford University Hospitals NHS Trust
Affiliation as printed
Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Department of Oncology, University of Oxford, Oxford, UK
-
Affiliation as printed
Champalimaud Foundation, Lisbon, Portugal
-
Affiliation as printed
Greater Poland Cancer Centre, Poznań, Poland
-
Affiliation as printed
Hull University Teaching Hospitals NHS Trust, Hull, UK
-
University of Leeds · Leeds Teaching Hospitals NHS Trust
Affiliation as printed
Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
Leeds Teaching Hospitals NHS Trust, Leeds, UK
-
Affiliation as printed
Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
-
Affiliation as printed
School of Engineering, Cardiff University, Cardiff, UK
-
Bank of Cyprus Oncology Center
Affiliation as printed
Bank of Cyprus Oncology Centre, Nicosia, Cyprus
-
Affiliation as printed
Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
-
Maastricht University Medical Centre
Affiliation as printed
Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre + , Maastricht, The Netherlands
-
University of Leeds · Leeds Teaching Hospitals NHS Trust
Affiliation as printed
Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
Leeds Teaching Hospitals NHS Trust, Leeds, UK
-
Affiliation as printed
School of Engineering, Cardiff University, Cardiff, UK
-
Affiliation as printed
Greater Poland Cancer Centre, Poznań, Poland
-
Affiliation as printed
Velindre University NHS Trust, Cardiff, UK
-
Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy
-
Affiliation as printed
Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia
Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
South Western Sydney Clinical Campus, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
-
Affiliation as printed
Hull University Teaching Hospitals NHS Trust, Hull, UK
-
Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy
-
Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy
-
Bank of Cyprus Oncology Center
Affiliation as printed
Bank of Cyprus Oncology Centre, Nicosia, Cyprus
-
Affiliation as printed
Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia
South Western Sydney Clinical Campus, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
-
Michael J. Eble Aachen
Affiliation as printed
RWTH Aachen University Medical Centre, Aachen, Germany
-
Affiliation as printed
Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia
South Western Sydney Clinical Campus, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
-
Goethe University Frankfurt · German Cancer Research Center · University Hospital Frankfurt · University Hospital Cologne · Frankfurt Cancer Institute · Deutsches Konsortium für Translationale Krebsforschung
Affiliation as printed
Frankfurt Cancer Institute (FCI), Frankfurt, Germany
German Cancer Research Center (DKFZ), Heidelberg, Germany, German Cancer Consortium (DKTK), Partner Site, Frankfurt, Germany
Goethe University Frankfurt, University Hospital, Department of Radiotherapy and Oncology, Frankfurt, Germany
University Hospital Cologne, Cologne, Germany
-
Bank of Cyprus Oncology Center
Affiliation as printed
Bank of Cyprus Oncology Centre, Nicosia, Cyprus
-
University of Leeds · St James's University Hospital
Affiliation as printed
Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
-
Cambridge University Hospitals NHS Foundation Trust
Affiliation as printed
Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
-
The University of Sydney · University of Wollongong
Affiliation as printed
Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia
Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
Institute of Medical Physics, The University of Sydney, Sydney, New South Wales, Australia
School of Electrical, Computer and Telecommunications Engineering, University of Wollongong, Wollongong, New South Wales, Australia
-
Thomas Jansen Aachen
Affiliation as printed
RWTH Aachen University Medical Centre, Aachen, Germany
-
The Netherlands Cancer Institute
Affiliation as printed
Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands
-
Bank of Cyprus Oncology Center
Affiliation as printed
Bank of Cyprus Oncology Centre, Nicosia, Cyprus
-
Cambridge University Hospitals NHS Foundation Trust
Affiliation as printed
Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
-
Affiliation as printed
Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia
South Western Sydney Clinical Campus, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
-
Leeds Teaching Hospitals NHS Trust
Affiliation as printed
Leeds Teaching Hospitals NHS Trust, Leeds, UK
-
Affiliation as printed
Hull University Teaching Hospitals NHS Trust, Hull, UK
-
Affiliation as printed
Champalimaud Foundation, Lisbon, Portugal
-
Cambridge University Hospitals NHS Foundation Trust
Affiliation as printed
Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
-
Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy
-
University Hospitals of Leicester NHS Trust
Affiliation as printed
University Hospitals of Leicester NHS Trust, Leicester, UK
-
Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy
-
The Christie NHS Foundation Trust
Affiliation as printed
The Christie NHS Foundation Trust, Manchester, UK
-
Bank of Cyprus Oncology Center
Affiliation as printed
Bank of Cyprus Oncology Centre, Nicosia, Cyprus
-
The Christie NHS Foundation Trust
Affiliation as printed
The Christie NHS Foundation Trust, Manchester, UK
-
Affiliation as printed
Velindre University NHS Trust, Cardiff, UK
-
Goethe University Frankfurt · German Cancer Research Center · University Hospital Frankfurt · Frankfurt Cancer Institute · Deutsches Konsortium für Translationale Krebsforschung
Affiliation as printed
Frankfurt Cancer Institute (FCI), Frankfurt, Germany
German Cancer Research Center (DKFZ), Heidelberg, Germany, German Cancer Consortium (DKTK), Partner Site, Frankfurt, Germany
Goethe University Frankfurt, University Hospital, Department of Radiotherapy and Oncology, Frankfurt, Germany
-
Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy
-
Affiliation as printed
Hull University Teaching Hospitals NHS Trust, Hull, UK
-
Affiliation as printed
Champalimaud Foundation, Lisbon, Portugal
-
Bank of Cyprus Oncology Center
Affiliation as printed
Bank of Cyprus Oncology Centre, Nicosia, Cyprus
-
The University of Sydney · University of Leeds · St James's University Hospital
Affiliation as printed
Institute of Medical Physics, The University of Sydney, Sydney, New South Wales, Australia
Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
-
Affiliation as printed
Greater Poland Cancer Centre, Poznań, Poland
-
Università Cattolica del Sacro Cuore · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico
Affiliation as printed
Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy
-
The Netherlands Cancer Institute
Affiliation as printed
Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands
-
The Netherlands Cancer Institute
Affiliation as printed
Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands
-
University of Wollongong · UNSW Sydney
Affiliation as printed
Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, Sydney, New South Wales, Australia
Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
South Western Sydney Clinical Campus, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
Cited by 2 stored of 2
2 results
No patents citing this paper on Lens.org (checked 2026-10-06).