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bioRxiv

Hierarchical Temporal Transformer for Cancer Grade Prediction and Cross-Cancer Transfer Learning from Pathology Reports

This work presents the Hierarchical Temporal Transformer (HTT), a two-level architecture in which level 1 encodes each report with BiomedBERT adapted by LoRA and level 2 is a temporal transformer that reads a patient's full report sequence using a continuous-time positional encoding built from the measured number of days between visits plus learnable cancer-type embeddings; on a controlled synthetic corpus of sequential radiology reports it reaches validation AUROC 0.942 versus 0.881 for a single-report baseline and transfers to held-out pancreatic cancer at 0.995 versus 0.949, and on 4,786 real pathology reports from TCGA-Reports spanning 14 cancer types it predicts tumor grade for three types withheld entirely from training with AUROC 1.000 on thyroid carcinoma, 0.960 on sarcoma and 0.