What is the staging system most often used in mesothelioma? Describe the stages. Briefly describe the other two systems used in staging mesothelioma.
The Butchart System is used most often and is based on the extent of the primary tumor mass. The stages are as follows:
• Stage I: Tumor is limited to the right or left pleura; it may also involve the ipsilateral diaphragm.
• Stage II: Tumor involves the chest wall, esophagus, heart, or pleural surfaces bilaterally; adenopathy in the chest is present.
• Stage III: Tumor has penetrated through the diaphragm to the abdomen; there is adenopathy beyond the chest.
• Stage IV: Metastatic disease is present in other organs throughout the body.
The TNM System (Stage I – V) is based on T (tumor), N (nodes) and M (metastases). The stages quantify levels of tumor involvement, presence of lymph nodes and presence of metastases.
The Brigham System (Stage I – IV) stages mesotheliomas based on the resectability of the tumor and status of lymph node involvement.