Multimodal learning that integrates histopathology images and genomic data holds great promise for cancer survival prediction. However, existing methods face key limitations: 1) They rely on multimodal mapping and metrics in Euclidean space, which cannot fully capture the hierarchical structures in histopathology (among patches from different resolutions) and genomics data (from genes to pathways). 2) They discretize survival time into independent risk intervals, which ignores its continuous and ordinal nature and fails to achieve effective optimization. 3) They treat censorship as a binary indicator, excluding censored samples from model optimization and not making full use of them. To address these challenges, we propose HySurvPred, a novel framework for survival prediction that integrates three key modules: Multimodal Hyperbolic Mapping (MHM), Angle-aware Ranking-based Contrastive Loss (ARCL) and Censor-Conditioned Uncertainty Constraint (CUC). Instead of relying on Euclidean space, we design the MHM module to explore the inherent hierarchical structures within each modality in hyperbolic space. To better integrate multimodal features in hyperbolic space, we introduce the ARCL module, which uses ranking-based contrastive learning to preserve the ordinal nature of survival time, along with the CUC module to fully explore the censored data. Extensive experiments demonstrate that our method outperforms state-of-the-art methods on five benchmark datasets. The source code is to be released.

Recent advancements in computational pathology have produced patch-level Multi-modal Large Language Models (MLLMs), but these models are limited by their inability to analyze whole slide images (WSIs) comprehensively and their tendency to bypass crucial morphological features that pathologists rely on for diagnosis. To address these challenges, we first introduce WSI-Bench, a large-scale morphology-aware benchmark containing 180k VQA pairs from 9,850 WSIs across 30 cancer types, designed to evaluate MLLMs' understanding of morphological characteristics crucial for accurate diagnosis. Building upon this benchmark, we present WSI-LLaVA, a novel framework for gigapixel WSI understanding that employs a three-stage training approach: WSI-text alignment, feature space alignment, and task-specific instruction tuning. To better assess model performance in pathological contexts, we develop two specialized WSI metrics: WSI-Precision and WSI-Relevance. Experimental results demonstrate that WSI-LLaVA outperforms existing models across all capability dimensions, with a significant improvement in morphological analysis, establishing a clear correlation between morphological understanding and diagnostic accuracy.