Look a Group at Once: Multi-Slide Modeling for Survival Prediction

Abstract

Survival prediction is a critical task in pathology. In clinical practice, pathologists often examine multiple cases, leveraging a broader spectrum of cancer phenotypes to enhance pathological assessment. Despite significant advancements in deep learning, current solutions typically model each slide as a sample, struggling to effectively capture comparable and slide-agnostic pathological features. In this paper, we introduce GroupMIL, a novel framework inspired by the clinical practice of collective analysis, which models multiple slides as a single sample and organizes groups of patches and slides sequentially to capture cross-slide prognostic features. We also present GPAMamba, a model designed to facilitate intra- and inter-slide feature interactions, effectively capturing local micro-environmental characteristics within slide-level graphs while uncovering essential prognostic patterns across an extended patch sequence within the group framework. Furthermore, we develop a dual-head predictor that delivers comprehensive survival risk and probability assessments for each patient. Extensive empirical evaluations demonstrate that our model significantly outperforms state-of-the-art approaches across five datasets from The Cancer Genome Atlas.