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History:
Originally proposed by H.J. Jewett in 1946; revised by Marshall
in 1956. Also called Jewett-Marshall Staging and AUS (American
Urologic System).
Criteria:
Histologic staging based on depth of invasion through the
bladder wall. It does not consider grade of tumor, local recurrence
rate or multicentricity of tumors. It's important to have
a deep resection.
Categories:
| Stage A |
Submucosal invasion but no
involvement of muscle |
| Stage B |
Bladder wall or muscle invasion,
subdivided B1 superficial and B2 deep |
| Stage C |
Extension through serosa into
perivesical fat (around bladder) |
| Stage D |
Lymph node and distant metastases,
subdivided D1 regional nodes and D2 distant nodes and
other distant metastases |
Guidelines for Jewett Staging:
- It is important to have a good surgical or biopsy specimen
so that muscle layers can be seen and assessed.
- The prognostic dividing line is between B1 and B2, so
be mindful of the description of the depth of muscle invasion.
- AJCC Tumor notation T1 to T4 parallels Jewett stages A,
B, C, D; N (node) and M (metastases) are part of Jewett
stage D.
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