According to the Dukes and TNM staging correlation for rectal carcinoma, which statement correctly pairs TNM stage with Dukes classification and corresponding 5-year survival?
- A Dukes A = T1-T2 N0 M0, tumour confined to/through muscularis propria, ~90% 5-year survival ✓
- B Dukes B = T3 N1 M0, transmural extension with nodal involvement, ~60% survival
- C Dukes C = T1-T4 N2 M0, any nodal involvement, ~35% survival
- D Dukes D = T4 N1 M1, peritoneal invasion with solitary liver metastasis, ~5% survival
Correct answer: A. Dukes A = T1-T2 N0 M0, tumour confined to/through muscularis propria, ~90% 5-year survival
Explanation
Dukes A corresponds to tumour confined to the bowel wall (T1-T2 N0), carrying ~90% 5-year survival. Dukes B is transmural extension without nodal involvement (T3-T4 N0), ~70% survival. Dukes C is any T with nodal metastases (N1-N2), subdivided into C1 (nodes near primary) and C2 (apical nodes), approximately 35-50% survival. Dukes D represents distant metastasis (M1 in any T/N), carrying poorest prognosis. Option B is incorrect as Dukes B excludes nodal involvement. Option C is partially correct but the survival figure is reasonable for C2 only.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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