# SCMIL: Sparse Context-aware Multiple Instance Learning for Predicting Cancer Survival Probability Distribution in Whole Slide Images

arXiv: https://arxiv.org/abs/2407.00664 · HTML: https://mlsanity.com/paper/2407.00664/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Builds on 18 of its 26 references that are in the map.
- First posted on arXiv 30 Jun 2024.

## Builds on (most cited first, 18 of 18)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Semi-Supervised Classification with Graph Convolutional Networks](https://mlsanity.com/paper/1609.02907/) (2016)
- [Inductive Representation Learning on Large Graphs](https://mlsanity.com/paper/1706.02216/) (2017)
- [How Powerful are Graph Neural Networks?](https://mlsanity.com/paper/1810.00826/) (2018)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Data Efficient and Weakly Supervised Computational Pathology on Whole Slide Images](https://mlsanity.com/paper/2004.09666/) (2020)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [Nystr"omformer: A Nystr"om-Based Algorithm for Approximating Self-Attention](https://mlsanity.com/paper/2102.03902/) (2021)
- [Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learning](https://mlsanity.com/paper/2206.02647/) (2022)
- [Whole Slide Images based Cancer Survival Prediction using Attention Guided Deep Multiple Instance Learning Networks](https://mlsanity.com/paper/2009.11169/) (2020)
- [Benchmarking Self-Supervised Learning on Diverse Pathology Datasets](https://mlsanity.com/paper/2212.04690/) (2022)
- [Whole Slide Images are 2D Point Clouds: Context-Aware Survival Prediction using Patch-based Graph Convolutional Networks](https://mlsanity.com/paper/2107.13048/) (2021)
- [Machine Learning for Survival Analysis: A Survey](https://mlsanity.com/paper/1708.04649/) (2017)
- [Machine Learning in Python: Main developments and technology trends in data science, machine learning, and artificial intelligence](https://mlsanity.com/paper/2002.04803/) (2020)
- [Effective Ways to Build and Evaluate Individual Survival Distributions](https://mlsanity.com/paper/1811.11347/) (2018)
- [Survival Mixture Density Networks](https://mlsanity.com/paper/2208.10759/) (2022)

## Built on by (most cited first, 8 of 8)

- [Multi-View Stenosis Classification Leveraging Transformer-Based Multiple-Instance Learning Using Real-World Clinical Data](https://mlsanity.com/paper/2602.02067/) (2026)
- [CrossFusion: A Multi-Scale Cross-Attention Convolutional Fusion Model for Cancer Survival Prediction](https://mlsanity.com/paper/2503.02064/) (2025)
- [Survival Modeling from Whole Slide Images via Patch-Level Graph Clustering and Mixture Density Experts](https://mlsanity.com/paper/2507.16476/) (2025)
- [Multimodal Feature Prototype Learning for Interpretable and Discriminative Cancer Survival Prediction](https://mlsanity.com/paper/2510.06113/) (2025)
- [Fourier Transform Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2510.15138/) (2025)
- [Spatially-Aware Mixture of Experts with Log-Logistic Survival Modeling for Whole-Slide Images](https://mlsanity.com/paper/2511.06266/) (2025)
- [Structural Prognostic Event Modeling for Multimodal Cancer Survival Analysis](https://mlsanity.com/paper/2512.01116/) (2025)
- [PA-MIL: Phenotype-Aware Multiple Instance Learning Guided by Language Prompting and Genotype-to-Phenotype Relationships](https://mlsanity.com/paper/2602.02558/) (2026)

## Abstract (arXiv)

Cancer survival prediction is a challenging task that involves analyzing of the tumor microenvironment within Whole Slide Image (WSI). Previous methods cannot effectively capture the intricate interaction features among instances within the local area of WSI. Moreover, existing methods for cancer survival prediction based on WSI often fail to provide better clinically meaningful predictions. To overcome these challenges, we propose a Sparse Context-aware Multiple Instance Learning (SCMIL) framework for predicting cancer survival probability distributions. SCMIL innovatively segments patches into various clusters based on their morphological features and spatial location information, subsequently leveraging sparse self-attention to discern the relationships between these patches with a context-aware perspective. Considering many patches are irrelevant to the task, we introduce a learnable patch filtering module called SoftFilter, which ensures that only interactions between task-relevant patches are considered. To enhance the clinical relevance of our prediction, we propose a register-based mixture density network to forecast the survival probability distribution for individual patients. We evaluate SCMIL on two public WSI datasets from the The Cancer Genome Atlas (TCGA) specifically focusing on lung adenocarcinom (LUAD) and kidney renal clear cell carcinoma (KIRC). Our experimental results indicate that SCMIL outperforms current state-of-the-art methods for survival prediction, offering more clinically meaningful and interpretable outcomes. Our code is accessible at https://github.com/yang-ze-kang/SCMIL.