Luca Cotugno | Searcharxiv

arXiv2026

Adaptation Interfaces for In-Context Tabular Foundation Models in Time-to-Event Prediction

Tabular foundation models (TabFMs) achieve strong performance on structured data, particularly for standard classification and regression problems. Yet, extending them to censored time-to-event prediction is challenging because it requires properly handling censoring and event-time dynamics. Building on our prior work, we further link TabFMs with CoxPH and DeepHit and revise the context-resampled training procedure. We evaluate temporal zero-shot reformulation, classification-based fine-tuning, and survival-head adaptation using frozen TabFM backbones on 74 single-risk data sets, and we additionally study 4 competing-risk data sets. Zero-shot inference is effective on smaller single-risk data sets, whereas supervised adaptation becomes increasingly advantageous as data sets scale. Cox provides the most reliably strong interface, especially for Integrated Brier Score (IBS) on larger data sets. DeepHit is relatively stronger for the time-dependent Concordance Index than for IBS, while cause-specific MTLR ranks highest among the TabFM survival heads in the four-data-set competing-risk analysis. Classification fine-tuning becomes more competitive with zero-shot inference as data sets grow but remains weaker for probabilistic prediction. Overall, our results indicate that effective TabFM transfer depends on the data regime and on the statistical structure represented by the chosen adaptation interface. The implementation scripts used for this work are available at https://github.com/kaylode/survival-fm.

cs.LG↗

arXiv2026

Tabular Foundation Models for Clinical Survival Analysis via Survival-Aware Adaptation

Predicting time-to-event outcomes such as mortality is a fundamental task in clinical decision-making, commonly addressed through survival analysis. While classical statistical and deep learning approaches have been widely studied, they typically require task-specific training and sufficient labeled data. Recent advances in tabular foundation models offer a new paradigm by learning general-purpose representations for structured data. However, their applicability to censored time-to-event prediction in clinical settings remains underexplored, as typical applications are restricted to discrete classification rather than survival analysis tasks. In this work, we propose a lightweight adaptation approach for applying tabular foundation models to clinical survival analysis by directly training a survival-aware head on top of the pretrained representations. We study representative architectures, including TabPFN, TabDPT, and TabICL, and adapt them using a multi-task logistic regression (MTLR) head to model right-censored time-to-event outcomes. We evaluate this approach on a diverse set of public survival benchmarks and two large-scale ICU cohorts, MIMIC-IV and eICU. Our results show that this transfer learning approach achieves competitive or superior performance compared to strong baselines. On MIMIC-IV, TabDPT-FT-MTLR reaches a C-index of 0.856, corresponding to a relative improvement of +1.4% over the best non-FM baseline (DeepSurv, 0.844) and +6.7% over the best zero-shot model (0.802). On eICU, TabICL-FT-MTLR achieves 0.797, yielding gains of +1.7% (DeepSurv, 0.784) and +6.4% (0.749), respectively. These findings highlight the importance of combining pretrained tabular representations with survival-aware objectives and suggest that tabular foundation models provide a practical and effective alternative for clinical survival prediction.

cs.LG↗