Colorectal carcinoma – Duke Staging and Management

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
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)
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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