The Cox proportional hazards (CPH) model has been widely applied in survival analysis to estimate relative risks across different subjects given multiple covariates. Traditional CPH models rely on a linear combination of covariates weighted with coefficients as the log-risk function, which imposes a strong and restrictive assumption, limiting generalization. Recent deep learning methods enable non-linear log-risk functions. However, they often lack interpretability due to the end-to-end training mechanisms. The implementation of Kolmogorov-Arnold Networks (KAN) offers new possibilities for extending the CPH model with fully transparent and symbolic non-linear log-risk functions. In this paper, we introduce Generalized Cox Proportional Hazards (GCPH) model, a novel method for survival analysis that leverages KAN to enable a non-linear mapping from covariates to survival outcomes in a fully symbolic manner. GCPH maintains the interpretability of traditional CPH models while allowing for the estimation of non-linear log-risk functions. Experiments conducted on both synthetic data and various public benchmarks demonstrate that GCPH achieves competitive performance in terms of prediction accuracy and exhibits superior interpretability compared to current state-of-the-art methods.

Prognostication for lung cancer, a leading cause of mortality, remains a complex task, as it needs to quantify the associations of risk factors and health events spanning a patient's entire life. One challenge is that an individual's disease course involves non-terminal (e.g., disease progression) and terminal (e.g., death) events, which form semi-competing relationships. Our motivation comes from the Boston Lung Cancer Study, a large lung cancer survival cohort, which investigates how risk factors influence a patient's disease trajectory. Following developments in the prediction of time-to-event outcomes with neural networks, deep learning has become a focal area for the development of risk prediction methods in survival analysis. However, limited work has been done to predict multi-state or semi-competing risk outcomes, where a patient may experience adverse events such as disease progression prior to death. We propose a novel neural expectation-maximization algorithm to bridge the gap between classical statistical approaches and machine learning. Our algorithm enables estimation of the non-parametric baseline hazards of each state transition, risk functions of predictors, and the degree of dependence among different transitions, via a multi-task deep neural network with transition-specific sub-architectures. We apply our method to the Boston Lung Cancer Study and investigate the impact of clinical and genetic predictors on disease progression and mortality.