Anterior resection is done for a patient with rectal cancer. Post operatively he presents with pain. Biopsy shows involvement of muscular wall but no penetration. Out of the 13 lymph nodes, one is involved. But the high tide lymph node is not involved. Modified duke stage

Ans. (a) C1Ref Page 1209/ Schwartz 10th editionThough there were lots of named colonic cancer staging used.All are replaced by only TNM staging now.For exam point of view we still read those outdated stagings.DukesACMACDescriptionAAALimited to mucosa, N0 B1B1Penetration into Submucosa, not through Muscularis propria, N0BB2B2Penetration through Muscularis Propria, N0 B3Adherence to adjacent organs, N0CC1C1N+, Limited to bowel wall (B1) C2C2N+, Penetrates through Muscularis propria (B2) C3N+. Adherence to adjacent organs (B3)D Distant Mets* AC -- Astler Coller* MAC -- Modified Astler Coller* N0 -- Node negative* N+-Node positive* Remember Stage C means lymphnode involvement