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Staging of colorectal carcinoma using Duke system

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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