An international multi-centre study to develop and validate federated learning-based prognostic models for anal cancer
Abstract
Abstract Precision oncology relies on access to high-quality data for increasingly smaller patient subgroups. The international atomCAT consortium investigates the potential of federated learning to support this, using anal cancer as a rare cancer exemplar. Here, we show that federated multivariable Cox models trained across 14 centres (1428 patients) and externally validated in two additional centres (277 patients) achieve consistent calibration and discrimination during leave-one-centre-out and external validation (c-indices 0.68-0.79). Lower T stage, absence of nodal involvement, smaller tumour volume, female sex, younger age, and mitomycin- or cisplatin-based chemotherapy are associated with improved overall survival. Lower T stage, smaller tumour volume, and female sex are associated with improved locoregional control, while absence of nodal involvement and smaller tumour volume are associated with better freedom from distant metastases. These findings demonstrate that federated learning enables robust, privacy-preserving prognostic modelling for rare cancers using real-world data, supporting international collaboration without data sharing.
Article Details
Authors (69)
Stelios Theophanous
Per-Ivar Lønne
Ananya Choudhury
Maaike Berbee
Charlotte Deijen
Andre Dekker
Matthew Field
Maria Antonietta Gambacorta
Alexandra Gilbert
Marianne Grønlie Guren
Rashmi Jadon
Rohit Kochhar
Daniel Martin
Ahmed Allam Mohamed
Rebecca Muirhead
Oriol Parés
Łukasz Raszewski
Rajarshi Roy
Andrew Scarsbrook
David Sebag-Montefiore
Emiliano Spezi
Vassilios Vassiliou
Eirik Malinen
Leonard Wee
Ane Appelt
Richard Adams
Krystyna Adamska
Muhammad Amin
Nikola Dino Capocchiano
Philip Chlap
Peter Colley
Andrea Damiani
Viola De Luca
Antri Demetriou
Shrikant Deshpande
Michael J. Eble
Anthony Espinoza
Emmanouil Fokas
Loukia Georgiou
Ann Henry
Andrew Hoole
Lois C. Holloway
Thomas Jansen
Tomas Janssen
Alexandros Kritikopoulos
Joanna Y. G. Lau
Mark T. Lee
John Lilley
Gisela Lima
Patricia Lopes
Adam Loveday
Stefania Manfrida
Jenny Marsden
Carlotta Masciocchi
Joseph Mercer
Elisavet Papageorgiou
Gareth Price
Thomas Rackley
Claus Michael Rödel
Mariachiara Savino
Athina Sdrolia
Joep Stroom
Ioannis Stylianou
David Thwaites
Maciej Trojanowski
Vincenzo Valentini
Rens van Haveren
Baukelien van Triest
Amy Walker