International Journal of Colorectal Disease

, Volume 2, Issue 3, pp 123–138 | Cite as

Staging of colorectal cancer

  • P. H. Chapuis
  • M. F. Dixon
  • L. P. Fielding
  • P. H. Gordon
  • P. Hermanek
  • M. Kyriakos
  • S. D. Nathanson
  • R. C. Newland
  • G. D. Oates
  • P. Quirke
  • J. R. Jass


There is nothing more to add except that I believe this symposium to be of very great educational value. If you, the reader, are a surgeon I hope you will wish to share its message with your colleagues in the pathology department.


Public Health Internal Medicine Colorectal Cancer Pathology Department 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dukes CE (1932) The classification of cancer of the rectum. J Pathol Bacteriol 35:323–332Google Scholar
  2. 2.
    Turnbull RB, Kyle K, Watson FR, Spratt J (1967) Cancer of the colon: the influence of the no-touch isolation technique on survival rates. Ann Surg 166:420–427Google Scholar
  3. 3.
    Newland RC, Chapuis PH, Pheils MT, Macpherson JG (1981) The relationship of survival to staging and grading of colorectal cancer: a prospective study of 503 cases. Cancer 47:1424–1429Google Scholar
  4. 4.
    Davis NC, Newland RC (1983) Terminology and classification of colorectal adenocarcinoma: The Australian Clinicopathological Staging System. Aust NZ J Surg 53:211–221Google Scholar
  5. 5.
    Goligher JC (1976) The Dukes' A, B and C Categorisation of the extent of spread of carcinomas of the rectum. Surg Gynecol Obstet 143:793–794Google Scholar
  6. 6.
    Chapuis PH, Fisher R, Dent OF, Newland RC, Pheils MT (1985) The relationship between different staging methods and survival in colorectal carcinoma. Dis Colon Rectum 28:158–161Google Scholar
  7. 7.
    Newland RC, Chapuis PH, Smyth EJ (1987) The prognostic value of substaging colorectal carcinoma: a prospective study of 1117 cases with standardised pathology. Cancer (in press)Google Scholar
  8. 8.
    Chapuis PH, Dent OF, Fisher R, Newland RC, Pheils MT, Smyth E, Colquhoun K (1985) A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer. Br J Surg 72:698–702Google Scholar
  9. 9.
    Rubio CA, Emas S, Nylander G (1977) A critical reappraisal of Dukes' classification. Surg Gynecol Obstet 145:682–684Google Scholar
  10. 10.
    Smith DL, Signorino CE, De La Cruz TO, Lewis MI (1970) Staging of colonic and rectal carcinomas: a review of ten years' experience at a Private Hospital. Dis Colon Rectum 13:302–307Google Scholar
  11. 11.
    Roseman DL, Strauss AK (1980) Staging of carcinoma of the colon and rectum. Surg Gynecol Obstet 151:93–95Google Scholar
  12. 12.
    Karavias TL, Hirner A, Haring R (1980) Problems in classifying colorectal carcinomata — The Dukes-ABC-System. Coloproctology 2:241–244Google Scholar
  13. 13.
    Fitzgerald RH (1982) What is the Dukes' System for carcinoma of the rectum? Dis Colon Rectum 25:474–477Google Scholar
  14. 14.
    Zinkin LD (1983) A critical review of the classifications and staging of colorectal cancer. Dis Colon Rectum 26:37–43Google Scholar
  15. 15.
    Donegan WL, De Cosse JJ (1978) Pitfalls and controversies in the staging of colorectal carcinoma. In: Enker WE (ed) Carcinoma of the colon and rectum, Year Book Medical, Chicago London, pp 49–70Google Scholar
  16. 16.
    Kyriakos M (1985) The President's cancer, the Dukes classification, and confusion. Arch Pathol Lab Med 109:1963–1066Google Scholar
  17. 17.
    Marwick C (1986) Staging of President's cancer continues to stimulate discussion. JAMA 255:2533–2536Google Scholar
  18. 18.
    Kirklin JW, Dockerty MB, Waugh JM (1949) The role of the peritoneal reflection in the prognosis of carcinoma of the rectum and sigmoid colon. Surg Gynecol Obstet 88:326–331Google Scholar
  19. 19.
    Astler VB, Coller FA (1954) The prognostic significance of direct extension of carcinoma of the colon and rectum. Ann Surg 139:846–852Google Scholar
  20. 20.
    Chapuis PH, Dent OF, Newland RC, Bokey EL, Pheils MT (1986) An evaluation of the American Joint Committee pTNM Staging method for cancer of the colon and rectum. Dis Colon Rectum 29:6–10Google Scholar
  21. 21.
    Dukes CE, Bussey HJR (1958) The spread of rectal cancer and its effect on prognosis. Br J Cancer 12:309–320Google Scholar
  22. 22.
    Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Lancet 2:996–999Google Scholar
  23. 23.
    Talbot IC, Ritchie S, Leighton MA, Hughes AO, Bussey HJR, Morson BC (1980) The clinical significance of invasion of veins by rectal cancer. Br J Surg 67:439–442Google Scholar
  24. 24.
    Russell AH, Pelton J, Reheis CE, Wisbeck WM, Tong DY, Dawson LE (1985) Adenocarcinoma of the colon: an autopsy study with implications for new therapeutic strategies. Cancer 56:1446–1451Google Scholar
  25. 25.
    Phillips RK, Hittinger R, Blesovsky L, Frye JS, Fielding LP (1984) Local recurrence following ‘curative’ surgery for large bowel cancer II. The rectum and rectosigmoid. Br J Surg 71:17–20Google Scholar
  26. 26.
    Fielding LP, Phillips RKS, Frye JS, Hittinger R (1986) The prediction of outcome after curative resection for large bowel cancer. Lancet 2:904–907Google Scholar
  27. 27.
    Blenkinsopp WK, Stewart-Brown S, Blesovsky L, Kearney G, Fielding LP (1981) Histopathology reporting in large bowel cancer. J Clin Pathol 34:598–613Google Scholar
  28. 28.
    Nathanson SD, Schultz L, Tilley B, Kambouris A (1986) Carcinomas of the colon and rectum. A comparison of staging classifications. Am Surg 52:429–433Google Scholar
  29. 29.
    Ham AW, Cormack DH (1979) Histology, 8th edn. JB Lippincott, PhiladelphiaGoogle Scholar
  30. 30.
    Hermanek P (1986) Problems of pTNM classification of carcinoma of the stomach, colorectum and anal margin. Pathol Res Pract 181:296–300Google Scholar
  31. 31.
    Perzin KH, Fenoglio CM, Pascal RR (1983) Neoplastic diseases of the small and large intestine. In: Siverberg SG (ed) Principles and practice of surgical pathology. John Wiley, New York, p 921Google Scholar
  32. 32.
    Cohn I Jr, Nance FC (1977) The colon and rectum. In: Sabiston DC Jr (ed) Davis-Christopher textbook of surgery, 11th edn. WB Saunders, Philadelphia, p 1108Google Scholar
  33. 33.
    American Joint Committee on Cancer (1983) Manual for staging of cancer. In: Beahrs OH, Myers MD (eds). JB Lippincott, Philadelphia, pp 73–80Google Scholar
  34. 34.
    Hutter RVP, Sobin LH (1986) A universal staging system for cancer of the colon and rectum. Let there be light. Arch Pathol Lab Med 110:367–368Google Scholar
  35. 35.
    Thynne GS, Weiland LH, Moertel CG, Silvers A (1980) Correlation of histopathologic characteristics of primary tumour and uninvolved regional lymph nodes in Dukes' class C colonic carcinoma with prognosis. Mayo Clin Proc 55: 243–245Google Scholar
  36. 36.
    Wolmark N, Fisher B, Wieand HS (1986) The prognostic value of the modifications of the Dukes' C class of colorectal cancer. Ann Surg 203:115–122Google Scholar
  37. 37.
    Jass JR, Morson BC (1986) A universal staging system for cancer of the colon and rectum revisited. Arch Pathol Lab Med 110:1119 (Letter)Google Scholar
  38. 38.
    Gastrointestinal Tumour Study Group (1984) Adjuvant therapy of colon cancer — results of a prospectively randomized trial. N Engl J Med 310:737–743Google Scholar
  39. 39.
    Jass JR, Atkin WS, Cuzick J, Bussey HJR, Morson BC, Northover JMA, Todd IP (1986) The grading of rectal cancer: historical perspectives and a multivariate analysis of 447 cases. Histopathology 10:437–459Google Scholar
  40. 40.
    Buckwalter JA, Thomas MS, Kent H (1973) Colonic cancer — essential information for a pathologic report. Arch Pathol 95:366–370Google Scholar
  41. 41.
    Cawthorn SJ, Gibbs NM, Marks CG (1986) Clearance techniques for the detection of lymph nodes in colorectal cancer. Br J Surg 73:58–60Google Scholar
  42. 42.
    Jass JR, Miller K, Northover JMA (1986) Fat clearance method versus manual dissection of lymph nodes in specimens of rectal cancer. Int J Colorect Dis 1:155–156Google Scholar
  43. 43.
    Qizilbash A (1982) Pathologic studies in colorectal cancer. A guide to the surgical pathology examination of colorectal specimens and review of features of prognostic significance. Pathol Annu 17:1–46Google Scholar
  44. 44.
    Morson BC (1981) Histopathology reporting in large-bowel cancer. Br Med J 283:1493–1494Google Scholar
  45. 45.
    Buckwalter JA Jr, Kent TH (1973) Prognosis and surgical pathology of carcinoma of the colon. Surg Gynaecol Obstet 136:465–472Google Scholar
  46. 46.
    Thomas GDH, Dixon MF, Smeeton NC, Williams NS (1983) Observer variation in the histological grading of rectal carcinoma. J Clin Pathol 36:385–391Google Scholar
  47. 47.
    Quirke P, Durdey P, Dixon MF, Dyson JED, Williams NS, Bird CC (1987) The prognostic significance of DNA aneuploidy in rectal adenocarcinomas. J Pathol 151:285–291Google Scholar
  48. 48.
    Finan PJ, Quirke P, Dixon MF, Dyson JED, Giles GR, Bird CC (1986) Is DNA aneuploidy a good prognostic indicator in patients with advanced colorectal cancer? Br J Cancer 54:327–330Google Scholar
  49. 49.
    Chapuis PH, Newland RC, Payne JE, Macpherson JG, Pheils MT (1980) Preoperative carcinoembryonic antigen level and prognosis in colorectal cancer. Med J Aus 2:140–143Google Scholar
  50. 50.
    Freedman LS, Macaskill P, Smith AN (1984) Multivariate analysis of prognostic factors for operable rectal cancer. Lancet 2:733–736Google Scholar
  51. 51.
    Williams NS, Durdey P, Quirke P, Robinson PJ, Dyson JED, Dixon MF, Bird CC (1985) Pre-operative staging of rectal neoplasm and its impact on clinical management. Br J Surg 72:868–874Google Scholar
  52. 52.
    Zorzitto M, Germanson T, Cummings B, Boyd NF (1982) A method of clinical prognostic staging for patients with rectal cancer. Dis Colon Rectum 25:759–765Google Scholar
  53. 53.
    Nicholls RJ, Mason AY, Morson BC (1982) The clinical staging of rectal cancer. Br J Surg 69:404–409Google Scholar
  54. 54.
    Finlay IG, McArdle CS (1986) Occult hepatic metastases in colorectal carcinoma. Br J Surg 73:732–735Google Scholar
  55. 55.
    Jass JR, Love SB, Northover JMA (1987) A new prognostic classification of rectal cancer. Lancet 1:1303–1306Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • P. H. Chapuis
    • 1
  • M. F. Dixon
    • 2
  • L. P. Fielding
    • 3
  • P. H. Gordon
    • 4
  • P. Hermanek
    • 5
  • M. Kyriakos
    • 6
  • S. D. Nathanson
    • 7
  • R. C. Newland
    • 8
  • G. D. Oates
    • 9
  • P. Quirke
    • 10
  • J. R. Jass
    • 11
  1. 1.FRACS, Department of SurgeryUniversity of Sydney, Concord HospitalConcordAustralia
  2. 2.Department of PathologyUniversity of LeedsLeedsUK
  3. 3.Department of SurgeryYale University School of Medicine, St. Mary's HospitalWaterburyUSA
  4. 4.The Sir Mortimer B. Davis Jewish General HospitalMontrealCanada
  5. 5.Abteilung für Klinische Pathologie in der Chirurgischen Klinik der Universität Erlangen-Nürnberg, MaximiliansplatzErlangenFRG
  6. 6.Department of Surgical PathologyWashington University School of MedicineSt. LouisUSA
  7. 7.Departments of Surgery and BiostatisticsHenry Ford HospitalDetroitUSA
  8. 8.Department of Anatomical PathologyUniversity of Sydney, Concord HospitalConcordAustralia
  9. 9.Department of SurgeryThe General HospitalBirminghamUK
  10. 10.Department of PathologyUniversity of LeedsLeedsUK
  11. 11.Department of PathologySt. Mark's HospitalLondonUK

Personalised recommendations