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Background: A cancer biorepository that links a patient's demographic, clinico-pathologic and tissue molecular profile data is critical for translational research to develop personalized cancer treatment. We hypothesize that a surgeon-directed biorepository optimizes the collection of all necessary elements needed to build a complete, robust research resource.

Methods: All colorectal cancer patients treated at a university medical center and its affiliates were eligible for inclusion in the biorepository. All patients signed an Institutional Review Board-approved genetic consent form and medical release authorization. Data was collected from: an 18-page personal and family health questionnaire completed by the patient; a prospectively maintained clinical database which included oncologic outcomes; and molecular testing. Specimen collection for the biorepository included: serum, plasma and peripheral blood mononuclear cells as well as tumor and normal tissue maintained as snap frozen samples, cryovials and paraffin blocks. The patient cohort was divided into a surgeon-referred group and a clinician-referred group. The groups were analyzed with the primary outcome variable as complete collection of data (clinical data, blood samples and tissue collection). Statistical analysis was performed using Student's t-test.

Results: Since inception of the program in 2006, 452 patients were approached to join the registry and 430 (95%) patients have been enrolled. Of these, 124 patients were referred by their surgeon and consented at the time of surgery, and 306 patients were consented in a clinical setting or over the telephone. Of patients referred by their surgeon, tumor tissue, blood samples and clinical data were obtained in 119 patients; conversely, in patients referred by oncologists or other clinicians the combination of tumor tissue, blood samples and clinical data were obtained in 133 patients (96% vs. 43.5%, p<0.05). 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.

Conclusion: Surgeon-directed enrollment in a biorepository improves the ability to collect blood and tissue samples in conjunction with demographic and clinic-pathologic data. Surgeons should take a leadership role in the development of tumor biorepositories.