staging of colorectal carcinoma using Duke system

Last reviewed 05/2019

The Dukes system of staging colorectal carcinoma has gained the most widespread recognition.

  • A: tumour confined to the bowel wall
    • 97% 5 year survival

  • B: tumour extends across the bowel wall
    • 80% 5 year survival
    • if locally-invasive, dramatically worse prognosis

  • C: involvement of regional nodes
    • C1: only a few nodes are involved near the primary growth and the proximal nodes are free from metastases
      • approximately 60% 5 year survival
    • C2: proximal nodes are involved
      • approximately 30% 5 year survival

  • D: distant metastases
    • less than 5% 5 year survival

It should be noted that this is an extended classification as Duke originally described only 3 classes A, B and C.

Other systems include:

  • Kirklin's:
    • A: confined to submucosa
    • B1: confined to the bowel wall
    • B2: through the bowel wall

  • Astler-Coller:
    • C1: nodal involvement primarily confined to bowel wall
    • C2: nodal involvement through the bowel wall