Mesothelioma stages and staging system : Part – 3

TNM Staging System

This system considers three components; the first letter of each forming the name of the system. Doctors using TNM will look at the tumor, lymph nodes, and whether the cancer has metastasized. Like the Butchart system, it is divided into four stages.

Stage	Location
T1a	Limited to ipsilateral parietal pleura (including mediastinal and diaphragmatic pleura), with no involvement of visceral pleura
T1b	Ipsilateral parietal pleura (including mediastinal and diaphragmatic pleura), with scattered foci of visceral pleural involvement
T2	Ipsilateral pleural surface has at least 1 of the following: Diaphragmatic muscle involvement Confluent visceral pleural tumor involvement (including fissures) Extension from visceral pleura into pulmonary parenchyma
T3	Locally advanced but resectable tumor; each ipsilateral pleural surface has at least 1 of the following: Involvement of the endothoracic fascia Extension into the mediastinal fat Solitary, completely resectable tumor focus in chest wall soft tissues Nontransmural involvement of the pericardium
T4	Locally advanced, technically unresectable tumor; each ipsilateral pleural surface has at least 1 of the following: Diffuse extension or multifocal chest wall masses with or without rib destruction Direct transdiaphragmatic extension into the peritoneum Direct extension to contralateral pleura Direct extension to 1 or more mediastinal organs Direct extension into spine Extension through to internal surface of pericardium, with or without pericardial effusion or myocardial involvement
NX	Regional lymph nodes not assessable
N0	No regional lymph nodes metastases
N1	Metastases in ipsilateral bronchopulmonary or hilar lymph nodes
N2	Metastases in subcarinal or ipsilateral mediastinal lymph nodes, including ipsilateral internal mammary nodes
N3	Metastases in contralateral mediastinal, contralateral internal mammary, and ipsilateral or contralateral supraclavicular lymph nodes
MX	Distant metastases not assessable
M0	No distant metastases
M1	Distant metastases present