Which Dukes/TNM staging classification corresponds to a colorectal cancer invading through the muscularis propria into the pericolorectal tissues but not penetrating the peritoneum and with no nodal or distant metastasis?

• A Dukes B / T2N0M0
• B Dukes B / T3N0M0 ✓
• C Dukes C / T3N1M0
• D Dukes A / T1N0M0

Explanation

T3 disease is defined as tumor invading through the muscularis propria into the pericolorectal tissues (subserosa or non-peritonealized pericolic/perirectal tissues) without penetrating the visceral peritoneum. With N0M0, this is Stage II (Dukes B). Dukes A corresponds to tumor confined to bowel wall (T1 or T2, equivalent to within or through muscularis propria with no nodal involvement). Dukes C involves regional nodal metastasis. T4 involves peritoneal penetration or invasion of adjacent organs. This Dukes B / T3N0M0 category carries a 5-year survival of ~60–70% and adjuvant chemotherapy may be considered for high-risk features.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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