TNM stage | Duke’s stage | Description | 5 yr survival | Surgery | Chemotherapy | Radiotherapy |
0 – Tis, N0, M0 | Limited to mucosa | >95% | Local excision/polypectomy β Surveillance | No | No | |
Mnemonic | ||||||
I – T1-2, N0, M0 | A | A-Ok limited to bowel wall only | 90% | Wide surgical resection + Anastomosis | No | No |
II – T3-4, N0, M0 | B | Breached bowel wall (muscularis propria) | 70% | Wide surgical resection + Anastomosis | Adjuvant 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, M0 | C | Colorectal regional lymph node metastasis | 30% | Wide surgical resection + Anastomosis | FOLFOX or CapeOX | As above |
IV – any T, any N, M1 | D | Distant metastasis | 10% | Surgical resection for – obstruction, some patients with hepatic, lung and peritoneal metastases | FOLFOX or FOLFIRI + Biologics | As above + Bone and Brain metastases |