Dukes classification

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In 1932 The British Pathologist Dr Cuthbert Dukes (1890-1977) devised a famous classification system for colorectal cancer which is still in use today (albeit in several different forms)[1][2]

Dukes A: 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[3]

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 is a useful guide to the prognosis and management of the particular cancer, and is now widely used in many forms for various other malignancies.

[edit] 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. ^ 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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