Tackling Small Sample Survival Analysis via Transfer Learning: A Study of Colorectal Cancer Prognosis

TL;DR

This paper explores transfer learning techniques to improve survival analysis in small sample cancer prognosis, demonstrating significant performance gains across multiple models using colorectal cancer data.

Contribution

It introduces transfer learning methods tailored for survival models, including a novel transfer survival forest, to enhance predictions with limited data.

Findings

Transfer learning significantly improves model performance.

All models trained with as few as 50 samples show notable gains.

The highest performance was achieved by the transfer survival forest.

Abstract

Survival prognosis is crucial for medical informatics. Practitioners often confront small-sized clinical data, especially cancer patient cases, which can be insufficient to induce useful patterns for survival predictions. This study deals with small sample survival analysis by leveraging transfer learning, a useful machine learning technique that can enhance the target analysis with related knowledge pre-learned from other data. We propose and develop various transfer learning methods designed for common survival models. For parametric models such as DeepSurv, Cox-CC (Cox-based neural networks), and DeepHit (end-to-end deep learning model), we apply standard transfer learning techniques like pretraining and fine-tuning. For non-parametric models such as Random Survival Forest, we propose a new transfer survival forest (TSF) model that transfers tree structures from source tasks and fine-tunes them with target data. We evaluated the transfer learning methods on colorectal cancer (CRC) prognosis. The source data are 27,379 SEER CRC stage I patients, and the target data are 728 CRC stage I patients from the West China Hospital. When enhanced by transfer learning, Cox-CC's $C^{td}$ value was boosted from 0.7868 to 0.8111, DeepHit's from 0.8085 to 0.8135, DeepSurv's from 0.7722 to 0.8043, and RSF's from 0.7940 to 0.8297 (the highest performance). All models trained with data as small as 50 demonstrated even more significant improvement. Conclusions: Therefore, the current survival models used for cancer prognosis can be enhanced and improved by properly designed transfer learning techniques. The source code used in this study is available at https://github.com/YonghaoZhao722/TSF.