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Comprehensive evaluation of cross cancer generalization in histopathology segmentation models across 21 tumor types
Tillmann Bedau1, Christian Harder1, Abdulkader Al-Shughri1
1Institute of Pathology, University Hospital Cologne, Cologne, Germany; Medical Faculty, University of Cologne, Cologne, Germany.
Background:
Artificial intelligence has significantly advanced computational pathology by enabling high-resolution, clinical-grade tumor segmentation models with state-of-the-art diagnostic accuracy. Creating such models is resource-intensive, requiring substantial time and domain expertise. Additionally, deep learning models are typically restricted to single tumor types, making it challenging to develop separate models for each tumor type. Cross-cancer generalization of segmentation models could address this bottleneck and pave the way for pan-cancer segmentation models.
Methods:
We evaluated the cross-tumor generalization capability of five tissue segmentation models (breast, colon, lung, kidney, prostate) using 21 cancer types from The Cancer Genome Atlas, totaling over 7,700 whole slide images. Representative large tumor and benign regions were manually selected, and segmentation accuracy was evaluated using a semiquantitative scale (0-10).
Results:
Here we show that the lung model demonstrates excellent cross-cancer performance (overall mean score 7.9 ± 2.1), effectively segmenting tumor regions in many non-lung cancers with segmentation accuracy similar to its native domain in 11 of 19 other epithelial tumors and melanoma, achieving particularly strong results in ovarian cancer (9.2 ± 0.9). The breast and colon models also show strong cross-domain performance, while the kidney and prostate models exhibit more limited generalization. Overall, high-precision segmentation is achievable in most cancer types using existing models.
Conclusions:
Existing segmentation models generalize across multiple cancer types, reducing the need to develop new, entity-specific models from scratch. This cross-domain generalization enables fast-track model development and supports future creation of robust pan-cancer segmentation models. Leveraging these capabilities could accelerate clinical integration of pathology artificial intelligence tools and enable reproducible biomarker discovery.
