Mesothelioma Cancer Staging System

The stage of mesothelioma is mainly about pleural mesothelioma

International Staging System for Diffuse Malignant Pleural Mesothelioma
Tumor Size of mesothelioma
T1

• T1a
• Tumor limited to the ipsilateral parietal +/– mediastinal +/– diaphragmatic pleura
• No involvement of the visceral pleura
• T1b
• Tumor involving the ipsilateral parietal +/– mediastinal +/–diaphragmatic pleura
• Tumor also involving the visceral pleura

T2

• Tumor involving each of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features:
• involvement of diaphragmatic muscle
• extension of tumor from visceral pleura into the underlying pulmonary parenchyma

T3

• Describes locally advanced but potentially resectable tumor
• Tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features:
• involvement of the endothoracic fascia
• extension into the mediastinal fat
• solitary, completely resectable focus of tumor extending into the soft tissues of the chest wall
• non-transmural involvement of the pericardium

T4

• Describes locally advanced technically unresectable tumor
• Tumor involving all the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features:
• diffuse extension or multifocal masses of tumor in the chest wall, with or without associated rib destruction
• direct trans-diaphragmatic extension of tumor to the peritoneum
• direct extension of tumor to the contra-lateral pleura
• direct extension of tumor to mediastinal organs
• direct extension of tumor into the spine
• tumor extending through to the internal surface of the pericardium with or without a pericardial effusion; or tumor involving the myocardium

N-Lymph nodes

• NX Regional lymph nodes cannot be assessed
• N0 No regional lymph node metastases
• N1 Metastases in the ipsilateral bronchopulmonar or hilar lymph nodes
• N2 Metastases in the subcarinal or the ipsilateral mediastinal lymph nodes including the ipsilateral internal mammary nodes
• N3 Metastases in the contralateral mediastinal, contralateral internal mammary, ipsilateral, or contralateral supraclavicular lymph nodes

M-Metastases

• MX Presence of distant metastases cannot be assessed
• M0 No distant metastasis
• M1 Distant metastasis present

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