Brigham Staging System

It is the most recent staging system for mesothelioma and looks at variables such as lymph node status and tumor resectability (ability to surgically remove a tumor). The Brigham staging system consists of four stages:

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.

An important aspect is that as pleural mesothelioma is the most common among all types of cancer and occurs frequently, these staging systems are devised to mark its stages.

The three established and recognized clinical staging systems for mesothelioma are:

• The Butchart System
• TNM Staging
• The Brigham System

The Butchart Staging System:

Butchart is the oldest system and is still the most commonly used.  Its four stages are based on the extent of primary tumor mass.

Staging is the process of finding out how far the mesothelioma cancer has spread. Doctors determine which treatments to use based on the mesothelioma stage, or the severity of the disease. Staging of mesothelioma is based on imaging studies such as x-rays, CT scans, and MRI scans.

To keep a track of mesothelioma cancer, the extent of its spread and the size of tumor(s); mesothelioma has been divided into a few stages or staging systems. These mesothelioma staging systems keep a track of the development of cancer in the human body. The tests and scans when diagnosing cancer give some information about the stage. It is important because treatment is often decided according to the stage of a cancer.
Some elements common to most staging systems are:
• Location of the primary tumor.
• Size and number of the tumors.
• Lymph node involvement.
• Cell type and tumor grade.
• Metastasis.

Many cancer registries, such as the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER) use summary staging, a system used for all types of cancer. Summary staging groups cancer into five main categories:

• In situ – cancer that is present only in the layer of cells in which it began.

• Localized – cancer that is limited to the organ in which it began with no evidence of spread.

• Regional – cancer that has spread from the primary site to nearby lymph nodes or organs.

• Distant – cancer that has spread from the primary site to distant lymph nodes or organs.

• Unknown – cases where not enough information exists to indicate stage.