Mesothelioma Past Staging System

There are mesothelioma staging system that proposed in the past that not used anymore.

Mesothelioma Staging Proposed by Butchart:

• Mesothelioma Stage 1 Tumor confined within the “capsule” of the parietal pleura, i.e., involving only ipsilateral pleura, lung, pericardium, and diaphragm.
• Mesothelioma Stage 2 Tumor invading chest wall or involving mediastinal structures, e.g., esophagus, heart, opposite pleura. Lymph node involvement within the chest
• Mesothelioma Stage 3 Tumor penetrating diaphragm to involve peritoneum. Involvement of opposite pleura. Lymph node involvement outside the chest.
• Mesothelioma Stage 4 Distant blood-borne metastases.

Mesothelioma Staging Proposed by Chahinian53,54

• Stage I T1, N0, M0
• Stage II T1-2, N1, M0
• T2, N0, M0
• Stage III T3, any N, M0
• Stage IV T4, and N, M0, any M1

T = Primary tumor;
T1 = Limited to ipsilateral pleura only (parietal pleura, visceral pleura);
T2 = Superficial local invasion (diaphragm, endothoracic fascia, ipsilateral lung, fissures);
T3 = Deep local invasion (chest wall beyond endothoracic fascia);
T4 = Extensive direct invasion (opposite pleura, peritoneum, retroperitoneum);
N = Lymph nodes;
N0 = No positive lymph node;
N1 = Positive ipsilateral hilar nodes;
N2 = Positive mediastinal nodes;
N3 = Positive contralateral hilar nodes.
M = Metastases;
M0 = No metastases;
M1 = Metastases; blood-borne or lymphatic.

Source:
Butchart EG, Ashcroft T, Barnsley WC, Holden MP. Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura. Experience with 29 patients. Thorax 1976;31:15
Chahinian AP. Malignant mesothelioma. In: Greenspan EM, editor. Clinical interpretation and practice of cancer chemotherapy. New York, NY: Raven; 1982. p. 599.
Chahinian AP. Therapeutic modalities in malignant pleural mesothelioma. In: Chretien J, Hirsch A, editors. Diseases of the pleura. New York, NY: Masson; 1983. p. 224.

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