Dukes staging system for colorectal cancer

Last revised by Arlene Campos on 19 Jan 2024

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 This system is now mainly of historical interest as it has largely been replaced by the TNM staging system.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

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