Surgeon leadership enables development of a colorectal cancer biorepository

Background: We hypothesized that surgeons can improve the collection of all necessary elements (tissue and clinical data) needed to build a complete, robust research biorepository. Methods: All colorectal cancer patients treated at a university medical center and its affiliates were eligible for inclusion. Data were collected from an 18-page personal and family health questionnaire, a prospectively maintained clinical database, and molecular testing. Tissues included serum, plasma and peripheral blood mononuclear cells, and tumor and normal tissue. We compared 2 groups: the surgeon-referred group and the other clinician-referred group. The primary outcome was the complete collection of data (ie, preoperative/staging clinical data, blood samples, and tissue collection). Statistical analysis was performed using the Student t test. Results: Since 2006, 452 patients were approached, and 430 (95%) have been enrolled. Of these, 124 were referred by their surgeon, and 306 were consented in a clinic or over the telephone. Of patients referred by their surgeon, tumor tissue, blood samples, and preoperative/staging clinical data were obtained in 119 patients; conversely, in patients referred by oncologists or other clinicians, only 133 patients had complete data (96% vs 43.5%, P <.05). A total of 257 tissue samples were obtained from all patients. Additional testing has been performed on 228 specimens including immunohistochemistry, microsatellite testing, and genotype mutational analysis. Conclusions: Surgeon-directed enrollment in a biorepository improves the ability to collect blood and tissue samples. Surgeons should take a leadership role in the development of tumor biorepositories.