Whitmore-Jewett staging system

Last revised by Daniel J Bell on 13 Dec 2022

The Whitmore-Jewett staging system (also known as the Jewett staging system or ABCD system) is a superseded staging system for prostate cancer. It was developed by the American Urological Association (AUA). Most societies (including AUA) and clinicians now advocate and use the TNM staging system.

  • A: subclinical tumor: found incidentally (T1 in TNM)

    • A1: tissue resembles normal cells; found in a few chips from one lobe

    • A2: more extensive involvement

  • B: tumor palpable on digital rectal exam (DRE): no extraprostatic extension (T2 in TNM)

    • B1: less than 50% one lobe

    • B2: more than 50% one lobe

    • B3: both lobes

  • C: extracapsular extension (T3/T4 in TNM)

    • C1: unilateral, not seminal vesicles (T3a)

    • C2

      • bilateral, not seminal vesicles (T3b)

      • seminal vesicles (T3c)

      • bladder neck, external anal sphincter, and/or rectum (T4a)

      • levator muscles, and/or fixed to pelvic sidewall (T4b)

  • D: metastasis

    • D1: regional adenopathy (N1 in TNM)

    • D2: distant metastases (M staging in TNM)

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