Mesothelioma Staging

There are different classifications for mesothelioma developed by different authors over time:
Butchart (1979)

1. confined to the parietal pleura
2. invades the wall, mediastinal, thoracic organs and / or thoracic lymph nodes
3. invading the diaphragm , the pericardium to reach the heart , the contralateral pleura, the peritoneum or extrathoracic organs
4. presence of hematogenous metastases
Brigham (1993)

1. confined to the ipsilateral parietal pleura to the affected area, pericardium, lung and diaphragm ipsilateral
2. affected intrathoracic lymph nodes, and tumor as stage 1
3. extrathoracic tumor involvement without distant metastasis or positive lymph nodes outside the chest
4. Distant metastasis present
Sugarbaker (1999)

1. cancer confined to the parietal pleura completely resectable
2. Stage 1 of the same thing but with positive resection margins or lymph nodes involved intrathoracic
3. local extension or involvement of any mediastinal organ peritoneal
4. distant metastases
IMIG (1995, the most accurate according to the most)

• a: confined to the parietal pleura without involvement of the visceral
• b: isolated foci in the visceral pleura
2: involved the parietal pleura and the presence of one of the conditions listed below:
• involving the diaphragm
• involved the visceral pleura and extending to the lung parenchyma
3: locally advanced unresectable cancer: ipsilateral involvement always the conditions below:
• involved the band endothoracic
• completely resectable cancer that involves soft tissue and chest wall
• non-transmural involvement of the pericardium
4: advanced unresectable cancer
X: unidentified metastatic lymph nodes 0: absence of lymph node metastases 1: involved lymph nodes ipsilateral bronchopulmonary and pulmonary hilum 2: subcarinal metastases to lymph nodes or ipsilateral thoracic (including internal mammary) 3: lymph node involvement extended beyond the above locations
M X/0/1: not detectable / absent / distant metastases.

This system has the advantage of offering good comparisons t studies and clinical results, but:
• the distinction between T2 and T3 is minimal in terms of survival
• The N is equal to that of lung cancer, because