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DIASURV · USCAP
Validation of an AI-based Solution for Risk Stratification of Early Stage Melanoma Patients
Jérôme Chetritt, Céline Bossard, Sanae Salhi, Yahia Salhi
15 MAR 2025
Abstract
Background
There is a need to improve risk stratification of primary cutaneous melanomas to better inform and guide adjuvant treatment. Taking into account that hematoxylin and eosin (HE)-stained tumor tissue contains a large amount of clinically unexploited relevant morphological information, we evaluate AI-based tool, SmartProg-MEL, to predict survival outcomes in stages early melanoma patients from HE-stained whole-slide image (WSI).
Design
SmartProg was evaluated on a cohort of 50 primary cutaneous melanomas (IHP-MEL-3, 72% IA, 12% IB and 16% IIA) with complete follow-up over 5 years. The model assigns a high or low risk profiles to patients only based on the primary tumor WSI. The stratification is assessed based on the model capability to predict relapses and OS among high profile risks as well as the Kaplan-Meier curves for the two profiles.
Results
SmartProg-MEL predicts 38 patients as low risks (79% IA, 13% IB and 8% IIA) and 12 as high risks (50% IA, 8% IB and 42% IIA). Among the 7 deceased and 4 relapsed patients during the follow-up period, SmartProg assigned 4 (57%) and 2 (50%), respectively, to high risk profiles, see Fig. 1. Moreover, when looking at the survival curves, we can see that the two profiles are clearly separable and give a 5-year overall survival of 62% and 92%, respectively, for high and low risks (Fig. 2). Finally, we explore the composition of two risk profiles in terms of their clinicopathological factors. Figure 1 - 422 Figure 2 - 422
Conclusions
The AI-based stratification algorithm, SmartProg-MEL, demonstrates promising performance in identifying distinct risk profiles in early-stage melanoma patients based solely on HE-stained WSI. The ability to differentiate between high and low-risk groups with clearly separable survival curves indicates that this tool could play a valuable role in improving prognosis and guiding therapeutic decisions. Figure Viewer
