Sarma DP(1986): The Dukes classification of colorectal cancer(letter).JAMA 256:1447.

PMID: 3528540 [PubMed - indexed for MEDLINE]

The Dukes Classification of Coiorectal Cancer

To the Editor.In MEDICAL NEWS & 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 (Cl) 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; B, extending into extrarec-. tal tissue; _and __C, tumor in lymph nodes), most commonly referred to*as the "Dukes classification." It needs to be clarified that Charles Marwick refers to the Dukes 1929 article2 but defines the stages of rectal carcinoma as described by Dr Dukes in his 1932 article.3
PERSPECTIVES Deba P. Sarma, MD Veterans Administration Medical Center New Orleans
1. Marwick C: Staging of President's cancer continues to stimulate discussion. JAMA 1986;2S5:2533-2536. 2. Gordon-Watson C, Dukes C: The radium problem III. The treatment of carcinoma of the rectum with radium with an introduction on the spread of cancer of the rectum. Br J Surg 1929-19:,17:643-69. 3. Dukes CE: The classification of cancer of the rectum. J Pathoi Baamd 1932;35:323-:i32.

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