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September 19, 1986

The Dukes Classification of Colorectal Cancer

Author Affiliations

Veterans Administration Medical Center New Orleans

JAMA. 1986;256(11):1447. doi:10.1001/jama.1986.03380110053025

To the Editor.—  In MEDICAL NEWS & PERSPECTIVES in the May 16 issue, Charles Marwick1 accurately refers to the original 1929 article wherein Dr Cuthbert Dukes proposed a classification system for rectal cancer2: A cases, in which the tumor had extended into the submucosa, but not into the muscle coat; B cases, in which the tumor had extended into muscle coat but not into perirectal tissue; and C cases, in which the tumor had extended into perirectal tissue. B cases were further subdivided into Bl, in which the circular muscle was the limit of growth, and B2, in which the longitudinal muscle was reached. C cases were also subdivided into those without lymph node metastasis (C1) and those with lymph node metastasis (C2). Three years later, in 1932, Dr Dukes3 abandoned his 1929 original classification and proposed the A, B, C classification (A, limited to rectal wall;