A Deep Learning Approach for Overall Survival Analysis with Missing Values

One of the most challenging fields where Artificial Intelligence (AI) can be applied is lung cancer research, specifically non-small cell lung cancer (NSCLC). In particular, overall survival (OS) is a vital indicator of patient status, helping to identify subgroups with diverse survival probabilities, enabling tailored treatment and improved OS rates. In this analysis, there are two challenges to take into account. First, few studies effectively exploit the information available from each patient, leveraging both uncensored (i.e., dead) and censored (i.e., survivors) patients, considering also the death times. Second, the handling of incomplete data is a common issue in the medical field. This problem is typically tackled through the use of imputation methods. Our objective is to present an AI model able to overcome these limits, effectively learning from both censored and uncensored patients and their available features, for the prediction of OS for NSCLC patients. We present a novel approach to survival analysis in the context of NSCLC, which exploits the strengths of the transformer architecture accounting for only available features without requiring any imputation strategy. By making use of ad-hoc losses for OS, it accounts for both censored and uncensored patients, considering risks over time. We evaluated the results over a period of 6 years using different time granularities obtaining a Ct-index, a time-dependent variant of the C-index, of 71.97, 77.58 and 80.72 for time units of 1 month, 1 year and 2 years, respectively, outperforming all state-of-the-art methods regardless of the imputation method used.