Staging of colorectal cancer. The Australian clinico-pathological staging (ACPS) system compared with Dukes' system

A new system, the Australian Clinico-pathological Staging (ACPS) System, has recently been proposed for the recording and reporting of colorectal carcinoma. This system requires the accurate use of precise definitions, cooperation between surgeons and pathologist, and a complete pathology report. It utilizes all information available--clinical, radiologic, operative, pathologic--before a stage is allotted. This contrasts with Dukes' system, which is based solely on the pathologic examination of the resected carcinoma. It allows classifications of all cases of colorectal cancer seen, whether treated by resection, palliative surgery, local excision or not at all. The stage at presentation and the five-year survival of 490 patients with colorectal cancer are compared using the ACPS and Dukes' systems. Eighty-four cases were not classifiable under Dukes' system, and there was a significant difference in survival in one of the comparable groups of patients.