Evidence map›Paper›PMID 41832163›Full record

ArticleNature communications2026

An international multi-centre study to develop and validate federated learning-based prognostic models for anal cancer.

Stelios Theophanous, Per-Ivar Lønne, Ananya Choudhury, Maaike Berbee, Charlotte Deijen, Andre Dekker, Matthew Field, Maria Antonietta Gambacorta, Alexandra Gilbert, Marianne Grønlie Guren and 16 more

Abstract readMulticenter StudyValidation Study
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Stelios TheophanousLeeds Teaching Hospitals NHS Trust, Leeds, UK. stelios.theophanous@nhs.net.ORCID http://orcid.org/0000-0002-4148-3905
Per-Ivar LønneDepartment of Medical Physics, Oslo University Hospital, Oslo, Norway.ORCID http://orcid.org/0000-0002-4210-8031
Ananya ChoudhuryDepartment of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre + , Maastricht, The Netherlands.ORCID http://orcid.org/0000-0001-9847-8165
Maaike BerbeeDepartment of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre + , Maastricht, The Netherlands.
Charlotte DeijenDepartment of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands.
Andre DekkerDepartment of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre + , Maastricht, The Netherlands.ORCID http://orcid.org/0000-0002-0422-7996
Matthew FieldSouth Western Sydney Clinical Campus, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia.
Maria Antonietta GambacortaFondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica S.Cuore, Rome, Italy.
Alexandra GilbertLeeds Teaching Hospitals NHS Trust, Leeds, UK.
Marianne Grønlie GurenDepartment of Oncology, Oslo University Hospital, Oslo, Norway.ORCID http://orcid.org/0000-0003-0593-0218
Rashmi JadonCambridge University Hospital NHS Foundation Trust, Cambridge, UK.
Rohit KochharThe Christie NHS Foundation Trust, Manchester, UK.
Daniel MartinGoethe University Frankfurt, University Hospital, Department of Radiotherapy and Oncology, Frankfurt, Germany.
Ahmed Allam MohamedRWTH Aachen University Medical Centre, Aachen, Germany.
Rebecca MuirheadDepartment of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID http://orcid.org/0000-0002-1124-7549
Oriol ParésChampalimaud Foundation, Lisbon, Portugal.ORCID http://orcid.org/0000-0002-8254-7733
Łukasz RaszewskiGreater Poland Cancer Centre, Poznań, Poland.
Rajarshi RoyHull University Teaching Hospitals NHS Trust, Hull, UK.
Andrew ScarsbrookLeeds Teaching Hospitals NHS Trust, Leeds, UK.ORCID http://orcid.org/0000-0002-4243-032X
David Sebag-MontefioreLeeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
Emiliano SpeziSchool of Engineering, Cardiff University, Cardiff, UK.ORCID http://orcid.org/0000-0002-1452-8813
Vassilios VassiliouBank of Cyprus Oncology Centre, Nicosia, Cyprus.
Eirik MalinenDepartment of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
Leonard WeeDepartment of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre + , Maastricht, The Netherlands.ORCID http://orcid.org/0000-0003-1612-9055
Ane AppeltLeeds Teaching Hospitals NHS Trust, Leeds, UK.ORCID http://orcid.org/0000-0003-2792-9218
atomCAT Consortium

Funding

Cancer Research UK (CRUK) C19942/A28832Yorkshire Cancer Research L389AA
6 · The paper itself

Abstract

Precision oncology relies on access to high-quality data for increasingly smaller patient subgroups. The international atomCAT consortium investigates the potential of federated learning to support this, using anal cancer as a rare cancer exemplar. Here, we show that federated multivariable Cox models trained across 14 centres (1428 patients) and externally validated in two additional centres (277 patients) achieve consistent calibration and discrimination during leave-one-centre-out and external validation (c-indices 0.68-0.79). Lower T stage, absence of nodal involvement, smaller tumour volume, female sex, younger age, and mitomycin- or cisplatin-based chemotherapy are associated with improved overall survival. Lower T stage, smaller tumour volume, and female sex are associated with improved locoregional control, while absence of nodal involvement and smaller tumour volume are associated with better freedom from distant metastases. These findings demonstrate that federated learning enables robust, privacy-preserving prognostic modelling for rare cancers using real-world data, supporting international collaboration without data sharing.

Indexed as

Anus NeoplasmsFederated LearningAgedFemaleHumansMaleMiddle AgedMitomycinNeoplasm StagingPrognosisProportional Hazards ModelsTumor BurdenMitomycin

Identifiers

PMID41832163
PMCPMC13133161

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.