DPsurv: Dual-Prototype Evidential Fusion for Uncertainty-Aware and Interpretable Whole-Slide Image Survival Prediction

Pathology whole-slide images (WSIs) are widely used for cancer survival analysis because of their comprehensive histopathological information at both cellular and tissue levels, enabling quantitative, large-scale, and prognostically rich tumor feature analysis. However, most existing methods in WSI survival analysis struggle with limited interpretability and often overlook predictive uncertainty in heterogeneous slide images. In this paper, we propose DPsurv, a dual-prototype whole-slide image evidential fusion network that outputs uncertainty-aware survival intervals, while enabling interpretation of predictions through patch prototype assignment maps, component prototypes, and component-wise relative risk aggregation. Experiments on five publicly available datasets achieve the highest mean concordance index and the lowest mean integrated Brier score, validating the effectiveness and reliability of DPsurv. The interpretation of prediction results provides transparency at the feature, reasoning, and decision levels, thereby enhancing the trustworthiness and interpretability of DPsurv.