<prompt> 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 stageC1C2D1D2  <response>: 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named colonic cancer staging used.All are replaced by only TNM staging now.For exam point of view we still read those outdated stagings.DukesACMACDescriptionAAALimited to mucosa, N0 B1B1Penetration into Submucosa, not through Muscularis propria, N0BB2B2Penetration through Muscularis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 B3D Distant Mets AC -- Astler Coller MAC -- Modified Astler Coller N0 -- Node negative N-Node positive Remember Stage C means lymphnode involvement 