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May 16, 1986

Staging of President's cancer continues to stimulate discussion

JAMA. 1986;255(19):2533-2535. doi:10.1001/jama.1986.03370190015002

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To many who are involved with the staging of tumors of the large bowel, Dukes—it seems—reigns supreme, even over realms that Dukes himself never envisioned.

Nowhere is this more evident than in the argument over the staging of President Ronald Reagan's colon cancer. With the approaching first anniversary of the President's operation, which involved a resection of the ascending colon for a villous adenoma of the cecum that contained an adenocarcinoma, the issue still has not abated entirely.

Ironically, the confusion over the staging of the President's malignancy came at the very time when a new staging system for large-bowel malignancies was in the final phase of development. Some details of the new system are now being published, says Robert V. P. Hutter, MD, of St Barnabas Medical Center, Livingston, NJ. In Hutter's view, had the new system "existed at the time the President's cancer was treated, then a lot