Last Modified: 07/16/2012
Stage Information for Malignant Mesothelioma
Patients with stage I disease have a significantly better prognosis than those with more advanced stages. Because of the relative rarity of this disease, exact survival information based upon stage is limited.[1]
Definitions of TNMThe American Joint Committee on Cancer has designated staging by TNM classification to define malignant mesothelioma.[2]
International Mesothelioma Interest Group Staging System for Diffuse Malignant Pleural Mesothelioma
Table 1. Primary Tumor (T)a| aReprinted with permission from AJCC: Pleural mesothelioma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 271-7. | |
| TX | Primary tumor cannot be assessed. |
| T0 | No evidence of primary tumor. |
| T1 | Tumor limited to the ipsilateral parietal pleura with or without mediastinal pleura and with or without diaphragmatic pleural involvement. |
| T1a | No involvement of the visceral pleura. |
| T1b | 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: involvement of diaphragmatic muscle; extension of tumor from visceral pleura into the underlying pulmonary parenchyma. |
| T3 | 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: 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; nontransmural involvement of the pericardium. |
| T4 | Locally advanced technically unresectable tumor. Tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following: diffuse extension or multifocal masses of tumor in the chest wall, with or without associated rib destruction; direct transdiaphragmatic extension of tumor to the peritoneum; direct extension of tumor to the contralateral 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. |
Table 2. Regional Lymph Nodes (N)a
| aReprinted with permission from AJCC: Pleural mesothelioma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 271-7. | |
| NX | Regional lymph nodes cannot be assessed. |
| N0 | No regional lymph node metastases. |
| N1 | Metastases in the ipsilateral bronchopulmonary or hilar lymph nodes. |
| N2 | Metastases in the subcarinal or the ipsilateral mediastinal lymph nodes including the ipsilateral internal mammary and peridiaphragmatic nodes. |
| N3 | Metastases in the contralateral mediastinal, contralateral internal mammary, ipsilateral or contralateral supraclavicular lymph nodes. |
Table 3. Distant Metastasis (M)a
| aReprinted with permission from AJCC: Pleural mesothelioma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 271-7. | |
| M0 | No distant metastasis. |
| M1 | Distant metastasis present. |
Table 4. Anatomic Stage/Prognostic Groupsa
| Stage | T | N | M |
| aReprinted with permission from AJCC: Pleural mesothelioma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 271-7. | |||
| I | T1 | N0 | M0 |
| IA | T1a | N0 | M0 |
| IB | T1b | N0 | M0 |
| II | T2 | N0 | M0 |
| III | T1, T2 | N1 | M0 |
| T1, T2 | N2 | M0 | |
| T3 | N0, N1, N2 | M0 | |
| IV | T4 | Any N | M0 |
| Any T | N3 | M0 | |
| Any T | Any N | M1 | |
References
- Chahinian AP, Pass HI: Malignant mesothelioma. In: Holland JC, Frei E, eds.: Cancer Medicine e.5. 5th ed. Hamilton, Ontario: B.C. Decker Inc, 2000, pp 1293-1312.
- Pleural mesothelioma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 271-7.