PANA-Surv: A Pathway-Guided Adaptive Neighborhood Augmentation Framework Using KEGG Pathways for Multi-Omics Cancer Prognosis

Background/Objectives: Integrating multi-omics data for cancer prognosis remains a challenging problem in bioinformatics because molecular profiles are high-dimensional, heterogeneous, and structured by incomplete biological relationships. Pathway databases provide biologically meaningful prior knowledge for modeling gene-level associations, but the sparsity and local incompleteness of pathway-derived networks often limit the performance of graph-based survival models. This study aimed to develop a pathway-guided framework for improving multi-omics survival prediction and identifying biologically relevant prognostic signals. Methods: We proposed PANA-Surv, a pathway-guided adaptive neighborhood augmentation framework for multi-omics cancer survival analysis. In this framework, KEGG pathways were used to construct gene graphs, and gene-level multi-omics profiles were encoded as node features. A conditional variational autoencoder module (PANA-VAE) was designed to enhance local representations through neighborhood reconstruction and adaptive weighting. The augmented features were then integrated into a graph convolutional survival model optimized with the Cox partial likelihood. Results: PANA-Surv was evaluated on 10 cancer cohorts from The Cancer Genome Atlas (TCGA). The proposed method achieved the highest mean concordance index (C-index) among all compared models and significantly outperformed Cox-EN, DeepSurv, GraphSurv, and LAGProg (all p < 0.01). Ablation analyses showed that both neighborhood reconstruction and adaptive weighting contributed to the observed performance gains, and KEGG-guided graph construction was more effective than alternative graph construction strategies. In a breast cancer (BRCA) case study, PANA-Surv identified 18 prognostic genes, including 12 genes supported by previous studies and 6 potentially novel candidates. Conclusions: These findings indicate that the integration of pathway prior knowledge with adaptive local feature enhancement can improve multi-omics survival modeling and support the identification of biologically relevant prognostic signals associated with cancer outcomes.