This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
Dukes' initial staging system for rectal cancer is described in his paper (J Pathol Bacteriol 1932; 35:323-332).
Later, Dukes divided his original stage C (lymph node involvement) into two parts, Cl and C2 (Br J Surg 1935;23:395-413). Subsequently, R. S. Grinnell, MD (Ann Surg 1939;109:500-533) demonstrated that Dukes' system could also be applied to colon cancer. Thus, the Dukes staging system is as follows:
Stage A: Carcinoma limited to the wall of the rectum or colon; no extension beyond the wall; no lymph node involvement.
Stage B: Carcinoma extending to extrarectal tissues or beyond the wall of the colon by direct continuity; negative lymph nodes.
Stage Cl: Only regional lymph nodes involved or lymph nodes below the high point of the resection of the mesenteric blood vessels.
Stage C2: Lymph nodes involved at the high point of the resection of the mesenteric blood vessels.
In 1949, J. W. Kirklin, MD,
Marwick C. Three early staging systems. JAMA. 1986;255(19):2536. doi:10.1001/jama.1986.03370190018004