Dukes staging system for colorectal cancer
The Dukes staging system is a classification system for colorectal cancer. This system is now mainly of historical interest as it has largely been replaced by the TNM staging system. It is not recommended for clinical practice.
- Dukes A: invasion into but not through the bowel wall (90% 5 year survival)
- Dukes B: invasion through the bowel wall but not involving lymph nodes (70% 5 year survival)
- Dukes C: involvement of lymph nodes (30% 5 year survival)
- Dukes D: widespread metastases
Astler and Coller (1954) adapted the original Dukes system as follows:
- stage A: limited to mucosa
- stage B1: extending into muscularis propria but not penetrating through it; nodes not involved
- stage B2: penetrating through muscularis propria; nodes not involved
- stage C1: extending into muscularis propria but not penetrating through it; nodes involved
- stage C2: penetrating through muscularis propria; nodes involved
- stage D: distant metastatic spread
- 1. AJCC (American Joint Committee on Cancer) Cancer Staging Manual, 7th ed, Edge, SB, Byrd, DR, Compton, CC, et al (Eds), Springer, New York 2010.
- 2. ASTLER VB, COLLER FA. The prognostic significance of direct extension of carcinoma of the colon and rectum. Ann. Surg. 2003;139 (6): 846-52. Free text at pubmed - Pubmed citation
- 3. Dukes CE. The classification of cancer of the rectum. Journal of Pathological Bacteriology 1932;35:323