Leveraging Tumor Heterogeneity: Heterogeneous Graph Representation Learning for Cancer Survival Prediction in Whole Slide Images

Survival prediction is a significant challenge in cancer management. Tumor microenvironment is a highly sophisticated ecosystem consisting of cancer cells, immune cells, endothelial cells, fibroblasts, nerves and extracellular matrix. The intratumor heterogeneity and the interaction across multiple tissue types profoundly impact the prognosis. However, current methods often neglect the fact that the contribution to prognosis differs with tissue types. In this paper, we propose ProtoSurv, a novel heterogeneous graph model for WSI survival prediction. The learning process of ProtoSurv is not only driven by data but also incorporates pathological domain knowledge, including the awareness of tissue heterogeneity, the emphasis on prior knowledge of prognostic-related tissues, and the depiction of spatial interaction across multiple tissues. We validate ProtoSurv across five different cancer types from TCGA (i.e., BRCA, LGG, LUAD, COAD and PAAD), and demonstrate the superiority of our method over the state-of-the-art methods. Source code is available at https://github.com/wjx-error/ProtoSurv .