Accurate Prediction of Disease-Free and Overall Survival in Non-Small Cell Lung Cancer Using Patient-Level Multimodal Weakly Supervised Learning

With the rapid progress in artificial intelligence (AI) and digital pathology, prognosis prediction for non-small cell lung cancer (NSCLC) patients has become a critical component of personalized medicine. In this study, we developed a multimodal AI model that integrates whole-slide images and dense clinical data to predict disease-free survival (DFS) and overall survival (OS) with high accuracy for NSCLC patients undergoing surgery. Utilizing data from 618 patients at Beijing Chest Hospital, the model achieved outstanding performance, with areas under the curve of 0.8084 for predicting progression and 0.8021 for predicting death in the test set. Importantly, the model demonstrated accurate prediction of 5-year DFS and OS, achieving accuracies of 0.7680 for DFS and 0.7760 for OS. By categorizing patients into high-risk and low-risk groups, the model identified significant differences in survival outcomes, with hazard ratios of 4.85 for progression and 4.57 for death, both with p-values below 0.0001. Additionally, it uncovered novel digital biomarkers associated with poor prognosis, offering further insights into NSCLC treatment. This model has the potential to revolutionize postoperative decision-making by providing clinicians with a precise tool for predicting DFS and OS, thereby improving patient outcomes.