Prognostic prediction in soft-tissue sarcomas using deep learning and digital pathology of tumor and margin areas

The histological FNCLCC grade is the primary prognostic factor in soft-tissue sarcoma (STS) but fails to fully capture high risk patients. This study aimed to develop and validate a deep learning (DL) model to predict metastatic relapse-free survival (MFS) using digital hematoxylin and eosin-stained...

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Veröffentlicht in:Scientific reports Jg. 15; H. 1; S. 38534 - 17
Hauptverfasser: Michot, Audrey, Le, Van-Linh, Coindre, Jean-Michel, Velasco, Valérie, Soussi, Malika, Mesli, Nouria, Italiano, Antoine, Toulmonde, Maud, Le Cesne, Axel, Bonvalot, Sylvie, Vanhersecke, Lucile, Honoré, Charles, Ngo, Carine, Le Loarer, François, Saut, Olivier, Crombé, Amandine
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London Nature Publishing Group UK 04.11.2025
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ISSN:2045-2322, 2045-2322
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Zusammenfassung:The histological FNCLCC grade is the primary prognostic factor in soft-tissue sarcoma (STS) but fails to fully capture high risk patients. This study aimed to develop and validate a deep learning (DL) model to predict metastatic relapse-free survival (MFS) using digital hematoxylin and eosin-stained whole-slide images. A retrospective analysis was conducted on 308 STS patients from two cancer centers, divided into a training cohort (149 patients) and two independent validation cohorts (64 and 95 patients). Supervised multi-instance learning convolutional neural network models were trained on distinct tumor regions—center (C), periphery (P), and margins (R)—to optimize predictive performance. Univariable analysis showed DL models using tumor center (DL-C), periphery (DL-P), and their combination (DL-CP) were consistently associated with MFS across cohorts, while models incorporating margins (DL-R and DL-CPR) demonstrated less reliable associations. Multivariable Cox regression confirmed that high risk scores from DL models were independent predictors of MFS. The DL-CP model outperformed FNCLCC grading in prognostic accuracy, with c-indices ≥ 0.74 in validation cohorts. Adding tumor margin information did not improve predictions.DL models focusing on tumor center and periphery provide superior prognostic value in STS, offering a streamlined, effective approach for digital pathology-based risk stratification.
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-025-20804-1