In 1932 the British pathologist 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.
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