Pathological Staging and survival

Cuthburt Dukes described the first well accepted staging system for rectal cancer. The system was later used to stage colon cancer too. He depended on pathology rather than what the surgeon saw as he felt that the surgeon's observations were not as reliable as the pathological examination.

He did not describe Duke's stage D, this was added later as a modification.

Table 6: Duke's staging and survival in colorectal cancer. The survial in Duke's C appears lower than it does in most reports, this is because this includes those that would normally be reported as Duke's D

Stage	Description	5 year survival
A	Not breaching muscularis propria	80-85%
B	Through the muscularis propria	60-67%
C	Involving the lymph nodes	30-37%

Table 7: T part of TNM staging for colo-rectal cancer

T 1	Involves the submucosa
T 2	Involves muscularis propria
T 3	Into subserosa or non peritonealised peri-colic or peri rectal tissues
T 4	Through the visceral peritoneum or invading adjacent organs