Prostate Cancer Treatment Information

The Jewett staging system is as described below.

Stage A

Stage A is clinically undetectable tumor confined to the prostate gland and is an incidental finding at prostatic surgery.

Substage A1: well-differentiated with focal involvement, usually left untreated

Substage A2: moderately or poorly differentiated or involves multiple foci in the gland

Stage B

Stage B is tumor confined to the prostate gland.

Substage B0: nonpalpable, PSA-detected [17]

Substage B1: single nodule in 1 lobe of the prostate

Substage B2: more extensive involvement of 1 lobe or involvement of both lobes

Stage C

Stage C is a tumor clinically localized to the periprostatic area but extending through the prostatic capsule; seminal vesicles may be involved.

Substage C1: clinical extracapsular extension

Substage C2: extracapsular tumor producing bladder outlet or ureteral obstruction

Stage D

Stage D is metastatic disease.

Substage D0: clinically localized disease (prostate only) but persistently elevated enzymatic serum acid phosphatase titers

Substage D1: regional lymph nodes only

Substage D2: distant lymph nodes, metastases to bone or visceral organs

Substage D3: D2 prostate cancer patients who relapsed after adequate endocrine therapy

References:

1. Oesterling JE, Martin SK, Bergstralh EJ, et al.: The use of prostate-specific antigen in staging patients with newly diagnosed prostate cancer. Journal of the American Medical Association 269(1): 57-60, 1993.
2. Huncharek M, Muscat J: Serum prostate-specific antigen as a predictor of radiographic staging studies in newly diagnosed prostate cancer. Cancer Investigation 13(1): 31-35, 1995.
3. Oesterling JE, Brendler CB, Epstein JI, et al.: Correlation of clinical stage, serum prostatic acid phosphatase and preoperative Gleason grade with final pathological stage in 275 patients with clinically localized adenocarcinoma of the prostate. Journal of Urology 138(1): 92-98, 1987.
4. Daniels GF, McNeal JE, Stamey TA: Predictive value of contralateral biopsies in unilaterally palpable prostate cancer. Journal of Urology 147(3, Part 2): 870-874, 1992.
5. Schuessler WW, Pharand D, Vancaillie TG: Laparoscopic standard pelvic node dissection for carcinoma of the prostate: is it accurate? Journal of Urology 150(3): 898-901, 1993.
6. Stone NN, Stock RG, Unger P: Indications for seminal vesicle biopsy and laparoscopic pelvic lymph node dissection in men with localized carcinoma of the prostate. Journal of Urology 154(4): 1392-1396, 1995.
7. Fournier GR, Narayan P: Re-evaluation of the need for pelvic lymphadenectomy in low grade prostate cancer. British Journal of Urology 72(4): 484-488, 1993.
8. Smith JA, Scardino PT, Resnick MI, et al.: Transrectal ultrasound versus digital rectal examination for the staging of carcinoma of the prostate: results of a prospective, multi-institutional trial. Journal of Urology 157(3): 902-906, 1997.
9. Gerber GS, Goldberg R, Chodak GW: Local staging of prostate cancer by tumor volume, prostate-specific antigen, and transrectal ultrasound. Urology 40(4): 311-316, 1992.
10. Hanks GE, Krall JM, Pilepich MV, et al.: Comparison of pathologic and clinical evaluation of lymph nodes in prostate cancer: implications of RTOG data for patient management and trial design and stratification. International Journal of Radiation Oncology, Biology, Physics 23(2): 293-298, 1992.
11. Schiebler ML, Yankaskas BC, Tempany C, et al.: MR imaging in adenocarcinoma of the prostate: interobserver variation and efficacy for determining stage C disease. American Journal of Radiology 158(3): 559-562, 1992.
12. National Institutes of Health: National Institute of Health Consensus Development Conference statement: the management of clinically localized prostate cancer. Journal of the American Medical Association 258(19): 2727-2730, 1987.
13. Schiebler ML, Schnall MD, Pollack HM, et al.: Current role of MR imaging in the staging of adenocarcinoma of the prostate. Radiology 189(2): 339-352, 1993.
14. Jewett HJ: The present status of radical prostatectomy for stages A and B prostatic cancer. Urologic Clinics of North America 2(1): 105-124, 1975.
15. Prostate. In: American Joint Committee on Cancer: AJCC Cancer Staging Manual. Philadelphia, Pa: Lippincott-Raven Publishers, 5th ed., 1997, pp 219-224.
16. Montie JE: Staging of prostate cancer: current TNM classification and future prospects for prognostic factors. Cancer 75(7, Suppl): 1814-1818, 1995.
17. Bostwick DG, Myers RP, Oesterling JE, et al.: Staging of prostate cancer. Seminars in Surgical Oncology 10(1): 60-72, 1994.

Back to Content Page              <<  Back                      Next >>