LF2L: Loss Fusion Horizontal Federated Learning Across Heterogeneous Feature Spaces Using External Datasets Effectively: A Case Study in Second Primary Cancer Prediction

Federated learning has emerged as a potential solution to privacy concerns associated with using sensitive health data for training predictive models, particularly in personalised cancer care. This research investigates whether federated learning can support the development of robust models for predicting tumour progression in breast cancer patients while addressing four critical deployment pillars: transparency, scalability, security, and fairness. This study evaluates a federated learning framework using multimodal data, including clinical information, tumour characteristics, biomarker data, and patient demographics, alongside medical imaging data such as MRI scans, to model changes in tumour characteristics over time. The performance of the federated approach was compared with that of a centralised model trained on aggregated data. The report then further examines strategies to enhance secure model updates, maintain performance across patient subgroups, and support scalability across institutions. The findings assess whether federated learning can achieve predictive performance comparable to centralised learning while preserving data locality. These results contribute to understanding the feasibility of privacy-preserving, multimodal predictive modelling and support future applications such as digital twins to assist clinicians and patients in personalised treatment planning.

Privacy-sensitive and distributed characteristics of multi-center medical data bring severe obstacles to centralized modeling for accurate early prediction of sepsis. Federated learning (FL) has attracted growing attention as a promising framework for collaborative model development, as it allows multiple institutions to jointly train predictive models without directly sharing or centralizing raw data. Nevertheless, its practical performance, robustness, and privacy-preserving benefits remain insufficiently evaluated using real-world clinical datasets. To bridge this gap, this study systematically examines the application of federated learning to multi-center sepsis prediction. The experimental dataset consists of 648 clinically screened samples collected from three tertiary hospitals in China, with rigorous inclusion and exclusion criteria. We establish a centralized training paradigm as the performance baseline, and then implement a horizontal federated learning framework for distributed collaborative modeling. Extensive experimental results demonstrate that the federated learning-based model achieves highly comparable prediction accuracy to the centralized counterpart, while fundamentally avoiding privacy leakage. Further privacy security analysis verifies that malicious attackers cannot reconstruct the original patient data from the transmitted model parameters, indicating strong resistance against data reconstruction attacks. This work not only validates the practicality and security of federated learning in clinical sepsis prediction, but also provides a reliable and feasible solution for privacy-preserving multi-center medical collaboration.

Multi-modal learning has demonstrated strong potential in medical applications by integrating heterogeneous data sources such as medical imaging, clinical records, and genomics to improve predictive performance and support clinical decision-making. However, advances in this area are often constrained by two key challenges: the limited availability of well-curated, ready-to-use datasets that accurately reflect real-world conditions, where medical data are frequently collected inconsistently and are often incomplete; and the inherent difficulty of integrating heterogeneous data modalities. In this work, we introduce a newly curated multi-center, multi-modal, and longitudinal dataset designed to support the evaluation of a wide range of learning pipelines under realistic conditions. The dataset comprises a total of 1,365 lung cancer patients and has three imaging modalities (whole-slide images, CT scans, and PET scans), structured clinical data, transcriptomic, and longitudinal follow-up and treatment information. For each imaging modality the dataset contains more than one instance. Moreover, the dataset exhibits substantial and non-uniform missingness across modalities, making it well-suited for studying robust multi-modal fusion strategies. We further provide both uni-modal and multi-modal benchmarks on the task of 12-month overall survival prediction, disease-specific survival, as well as longitudinal benchmark of hazard prediction under severe missing data. Our results show that, despite high levels of missingness, integrating complementary modalities consistently improves predictive performance over uni-modal approaches, highlighting the value of multi-modal fusion in realistic clinical settings. The dataset and benchmark code are available at https://github.com/ritacmendes/MMIST-LUNG.