Dukes classification

Dukes classification

In 1932 the British pathologist Cuthbert Dukes (1890-1977) devised a famous classification system for colorectal cancer. Several different forms of the Dukes classification were developed.[1][2] However, this system has largely been replaced by the more detailed TNM staging system and is no longer recommended for use in clinical practice.[3]

Dukes' A[4]: Invasion into but not through the bowel wall
Dukes' B: Invasion through the bowel wall but not involving lymph nodes
Dukes' C: Involvement of lymph nodes
Dukes' D: Widespread metastases

An adaptation by the Americans Astler and Coller in 1954 further divided stages B and C[5]

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

The stage gives valuable information for the prognosis and management of the particular cancer.

References

  1. ^ Kyriakos M: The President cancer, the Dukes classification, and confusion, Arch Pathol Lab Med 109:1063, 1985
  2. ^ Dukes CE. The classification of cancer of the rectum. Journal of Pathological Bacteriology 1932;35:323
  3. ^ AJCC (American Joint Committee on Cancer) Cancer Staging Manual, 7th ed, Edge, SB, Byrd, DR, Compton, CC, et al (Eds), Springer, New York 2010. p 143.
  4. ^ Who Named It, showing correct grammatical usage
  5. ^ Astler VB, Coller FA: The prognostic significance of direct extension of carcinoma of the colon and rectum. Ann Surg 139:846, 1954

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