Integrating tumor location into artificial intelligence-based prognostic models in cancer

This letter is a commentary on the findings of Huang et al, who emphasize the prognostic value of tumor location in gastric cancer. Analyzing data from 3287 patients using Kaplan-Meier and multivariate Cox models, the authors found that the tumor location correlated with patient prognosis following surgery. Patients with tumors situated nearer to the stomach's proximal end were associated with shorter survival periods and poorer outcomes. Notably, gender-based differences in tumor markers, particularly carbohydrate antigen 72-4, further highlight the need for sex-specific influence on the tumor location. Despite increasing recognition of tumor location as a prognostic factor, its role remains unclear in clinical prediction models for various cancers. This letter highlights the potential of incorporating tumor location into artificial intelligence -based prognostic tools to enhance prognostic models. It also outlines a stepwise framework for developing these models, from retrospective training to prospective multicenter validation and clinical implementation. In addition, it addresses the technical, ethical, and interoperability challenges critical to successful real-world prognosis.