iMCN: information compression-based multimodal confidence-guided fusion network for cancer survival prediction

The rapid development of deep learning-based computational pathology and genomics has demonstrated the significant promise of effectively integrating whole slide images (WSIs) and genomic data for cancer survival prediction. However, the substantial heterogeneity between pathological and genomic features makes exploring complex cross-modal relationships and constructing comprehensive patient representations challenging. To address this, we propose the Information Compression-based Multimodal Confidence-guided Fusion Network (iMCN). The framework is built around two key modules. First, the Adaptive Pathology Information Compression (APIC) module employs learnable information centers to dynamically cluster image regions, removing redundant information while maintaining discriminative survival-related patterns. Second, the Confidence-guided Multimodal Fusion (CMF) module utilizes a learned sub-network to estimate the confidence of each modality's representation, allowing for dynamic weighted fusion that prioritizes the most reliable features in each case. Evaluated on the TCGA-LUAD and TCGA-BRCA cohorts, iMCN achieved average concordance index (C-index) values of 0.691 and 0.740, respectively, outperforming existing state-of-the-art methods by an absolute improvement of 1.65%. Qualitatively, the model generates interpretable heatmaps that localize high-association regions between specific morphological structures (e.g., tumor cell nests) and functional genomic pathways (e.g., oncogenesis), offering biological insights into genomic-pathologic linkages. In conclusion, iMCN significantly advances multimodal survival analysis by introducing a principled framework for information compression and confidence-based fusion. Besides, correlation analysis reveal that tissue heterogeneity influences optimal retention rates differently across cancer types, with higher-heterogeneity tumors (e.g., LUAD) benefiting more from aggressive information compression. Beyond its predictive performance, the model's ability to elucidate the interplay between tissue morphology and molecular biology enhances its value as a tool for translational cancer research.