Neural networks as a prognostic tool of surgical risk in lung resections
Abstract
Background Assessment of surgical risk in patients undergoing pulmonary resection is a fundamental goal for thoracic surgeons. Usually used risk indices do not predict the individual outcome. Neural networks (NN) are artificial intelligence software models that have been used for estimation of several prognostic situations. Methods Ninety-six clinical and laboratory features from each one of 141 patients who underwent lung resection were retrospectively collected. The variables were used as input data for the software. Cases were divided into a training set (n = 113) and a test set (n = 28). Four NN models were trained using the data from the training set: (1) using all variables; (2) using only the Goldman and Torrington scores; (3) using all variables except for the two scores. A fourth NN was programmed with all variables to estimate the development of major postoperative complications. The trained NN models were tested with the test set data. Results The NN using all variables with or without the scores were able to correctly classify all 28 test cases against actual outcome. The NN using all variables also estimated major postoperative complications correctly in all 28 test cases. The NN using only two indices (Goldman and Torrington) yielded 6 of 28 errors in classification. Conclusions These data suggest that NN can integrate results from multiple data predicting the individual outcome for patients, rather than assigning them to less-precise risk group categories.
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Esteva H et al. investigated artificial neural networks for estimating postoperative outcomes following lung resection; neural networks demonstrated greater flexibility and individualized predictive power, achieving nearly 100% sensitivity and specificity for patient outcomes.
“Esteva H, et al. investigated the use of artificial NN—modeled after the human neural system—for estimating postoperative outcomes following lung resection, comparing them to conventional risk indices. NN demonstrated greater flexibility and individualized predictive power, achieving nearly 100% sensitivity and specificity for patient outcomes [44].”
From Artificial Intelligence in Oncologic Thoracic Surgery: Clinical Decision Support and Emerging Applications (2026) · cites this paper as [44]
Traditional risk assessment tools such as the Goldman index for cardiac risk and the Torrington index for respiratory risk are effective in categorizing patients into broad risk categories but fall short in providing precise, individualized predictions of operative risk.
“Traditional risk assessment tools, such as the Goldman index for cardiac risk and the Torrington index for respiratory risk, are effective in categorizing patients into broad risk categories but fall short in providing precise, individualized predictions of operative risk [44].”
From Artificial Intelligence in Oncologic Thoracic Surgery: Clinical Decision Support and Emerging Applications (2026) · cites this paper as [44]
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Karalis, V. D. (2024) · Applied Biosciences · doi:10.3390/applbiosci3010002 · Cited by 255 · see citing works
Petrella, F., & Rizzo, S. (2026) · Cancers · doi:10.3390/cancers18020246 · Cited by 10 · see citing works
- Authors
- Esteva, H., Marchevsky, A., Núñez, T., Luna, C., & Esteva, M.
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2002-05
- Volume
- 73
- Issue
- 5
- Pages
- 1576-1581
- ISSN
- 0003-4975
- Cited by
- 35
- References
- 0
- Language
- en
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