From the Research
Modified Duke's Criteria
The Modified Duke's criteria for staging colon cancer involve the addition of various prognostic factors to the traditional Dukes system. These factors include:
- Percent of lymph node metastases 1
- Ulceration of the primary tumor 1
- Adjacent organ invasion 1
- Number of positive nodes 2, 3
- Depth of invasion 2
- Nuclear morphology, flow cytometric characteristics, histological grade, and vascular or lymphatic invasion 2
- The nature of the expanding margin of the tumour (pushing or infiltrating) and the presence or absence of lymphocytic infiltration within the tumour 4
Staging Systems
Various staging systems have been compared to the Dukes system, including:
- The pTNM system, which was found to be most sensitive at predicting death 1
- The Gastrointestinal Tumor Study Group (GITSG) system, which was found to be most specific at predicting survival 1
- The TNM system, which is recommended for use due to its ability to describe appropriate prognostic factors and allow conversion of other staging systems into a common format 2
- The Jass staging system, which uses biological criteria in addition to anatomical criteria 4
- A modified Dukes's classification, which subdivides Dukes's C cases according to the number of positive nodes or the level of positive nodes 3
- A modified staging system based on T and N descriptors, which was found to provide improved prognostication for colon cancer patients compared to the AJCC staging system 5