Cancer Survival Analysis via Zero-shot Tumor Microenvironment Segmentation on Low-resolution Whole Slide Pathology Images

The whole-slide pathology images (WSIs) are widely recognized as the golden standard for cancer survival analysis. However, due to the high-resolution of WSIs, the existing studies require dividing WSIs into patches and identify key components before building the survival prediction system, which is time-consuming and cannot reflect the overall spatial organization of WSIs. Inspired by the fact that the spatial interactions among different tumor microenvironment (TME) components in WSIs are associated with the cancer prognosis, some studies attempt to capture the complex interactions among different TME components to improve survival predictions. However, they require extra efforts for building the TME segmentation model, which involves substantial annotation workloads on different TME components and is independent to the construction of the survival prediction model. To address the above issues, we propose ZTSurv, a novel end-to-end cancer survival analysis framework via efficient zero-shot TME segmentation on low-resolution WSIs. Specifically, by leveraging tumor infiltrating lymphocyte (TIL) maps on the 50x down-sampled WSIs, ZTSurv enables zero-shot segmentation on other two important TME components (i.e., tumor and stroma) that can reduce the annotation efforts from the pathologists. Then, based on the visual and semantic information extracted from different TME components, we construct a heterogeneous graph to capture their spatial intersections for clinical outcome prediction. We validate ZTSurv across four cancer cohorts derived from The Cancer Genome Atlas (TCGA), and the experimental results indicate that our method can not only achieve superior prediction results but also significantly reduce the computational costs in comparison with the state-of-the-art methods.