Identify the 3 classification systems used to stage mesothelioma and the stages involved in each.
The Butchart System is the oldest staging system, the more recent is the TNM system, and the latest system used is the Brigham System. The Butchart System describes Stage 1 as involving the lining of one lung and the diaphragm on the same side, Stage 2 involves invasion into the chest wall, esophagus, heart, or involving both lungs, with possibily lymph nodes in chest being involved. Stage 3 involves the diaphragm extending into the lining of the abdominal cavity or peritoneum, and may effect lymph nodes beyond those in the chest. Stage 4 is the final stages and involves mets or spread of cancer to other organs. The TMN System Stage 1 involves the lining of one lung, the pericardium or diaphragm on the same side with no lymph node involvement. State 2 shows involvement of lymph nodes to the lung effected on the same side. Stage 3 involves chest wall muscle, ribs, heart, esophagus or other organs of the chest on the same side of the primary tumor. Stage 4 involves spread of disease to lymph nodes in the chest on the opposite side of the primary tumor, extends into the lung opposite the primary tumor, or extends directly into the organs of the abdominal cavity or neck. Mets are included in this stage. The Brigham system focuses on the resectability of the mass surgically. Stage 1 is that the tumor is resectable and lymph nodes are not involved. Stage 2 is mass is resectable but lymph nodes are involved. Stage 3 is mass is unresectable and extends into the chest wall, heart, or through the diaphragm, peritoneum, with or without lymph node involvement. Stage 4 occurs when doctors discover mets of distant organs.