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Mnemonics, Simplified Concepts & Thoughts

Colorectal carcinoma – Duke Staging and Management

Epomedicine, Jul 7, 2024Jul 7, 2024

Last updated on July 7, 2024

duke staging
Cancer Research UK, CC BY-SA 4.0, via Wikimedia Commons
TNM stageDuke’s stageDescription5 yr survivalSurgeryChemotherapyRadiotherapy
0 – Tis, N0, M0Limited to mucosa>95%Local excision/polypectomy → SurveillanceNoNo
Mnemonic
I – T1-2, N0, M0AA-Ok limited to bowel wall only90%Wide surgical resection + AnastomosisNoNo
II – T3-4, N0, M0BBreached bowel wall (muscularis propria)70%Wide surgical resection + AnastomosisAdjuvant if: lymph node sampling <12, poorly differentiated, local invasion, occlusion/perforation, pT4)
FOLFOX or CapeOX
Yes, for rectal cancer (give with 5-FU as sensitizer)
III – any T, N1-3, M0CColorectal regional lymph node metastasis30%Wide surgical resection + AnastomosisFOLFOX or CapeOXAs above
IV – any T, any N, M1DDistant metastasis10%Surgical resection for – obstruction, some patients with hepatic, lung and peritoneal metastasesFOLFOX or FOLFIRI + BiologicsAs above

+ Bone and Brain metastases
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PGMEE, MRCS, USMLE, MBBS, MD/MS Gastrointestinal systemGeneral SurgeryOncology

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Epomedicine. Colorectal carcinoma – Duke Staging and Management [Internet]. Epomedicine; 2024 Jul 7 [cited 2025 May 9]. Available from: https://epomedicine.com/medical-students/colorectal-carcinoma-duke-staging-and-management/.

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