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Updated: Jun 16, 2026

Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
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Comparing Resident Team Performance in Complex Surgical Oncology: A Single-Institution Cohort Study.

Rachael C Acker1,2,3, James E Sharpe4,5, Shane Williams4,5

  • 1Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA. rachael.acker@pennmedicine.upenn.edu.

Annals of Surgical Oncology
|June 14, 2026
PubMed
Summary

Patient outcomes in surgical oncology vary significantly among resident-led teams. Performance metrics like adverse events and length of stay can identify teams needing additional supervision for improved surgical quality.

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Area of Science:

  • Surgical Oncology
  • Healthcare Quality Improvement
  • Team Performance Metrics

Background:

  • Team dynamics significantly impact surgical patient outcomes, but data on resident-led teams are limited.
  • This study addresses the scarcity of information on resident-led teams in complex surgical oncology.
  • Patient outcomes were hypothesized to vary based on specific team assignments.

Purpose of the Study:

  • To compare patient outcomes among resident-led teams in complex surgical oncology.
  • To identify variations in team performance using objective outcome measures.
  • To establish a basis for performance feedback and supervision needs.

Main Methods:

  • Retrospective cohort study analyzing resident-led teams in surgical oncology (2018-2025).
  • Data sourced from the National Surgical Quality Improvement Project registry at a single university hospital.
  • Primary outcome: adverse events (mortality, complications); secondary outcomes: length of stay, 30-day readmissions. Mixed-effects regression used for risk-adjusted analysis.

Main Results:

  • 145 teams evaluated, caring for 2919 patients.
  • Five teams showed poor performance in risk-adjusted adverse event rates.
  • Variations observed in risk-adjusted length of stay and 30-day readmission rates across teams.

Conclusions:

  • Risk-adjusted patient outcomes provide a valid measure of performance variation in resident-led surgical oncology teams.
  • Benchmarking team performance can identify specific teams requiring enhanced supervision.
  • This approach supports targeted quality improvement initiatives in surgical training and care.