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5. Staging (mesothelioma)

5.1  Classification Criteria

May need to update to the AJCC 6th Edition

UICC Staging 1997
I Disease confined within the capsule of the parietal pleura: ipsilateral pleura, lung, pericardium, and diaphragm.
  T1 N0 MO
  T2 N0 M0
II All of stage I with positive intrathoracic (N1 or N2) lymph nodes.
  T1 N1 M0
  T2 N1 M0
III Local extension of disease into the following: chest wall or mediastinum: heart or through the diaphragm, periotoneum; with or without extrathoracic or contralateral (N3) lymph node involvement.
  T3 NO MO
  T3 N1 M0
  T1 N2 M0
  T2 N2 M0
  T3 N2 M0
IV Distant metastatic disease
  Any T N3 MO
  T4 any N M0
  Any T and N M1
T (Primary Tumour and Extent)
TX Primary tumour cannot be assessed
T0 No evidence of primary tumour
T1 Primary tumour limited to ipsilateral parietal or visceral pleura
T2 Tumour invades any of the following: ipsilateral lung, endothoracic fascia, diaphragm, pericardium
T3 Tumour invades any of the following: ipsilateral chest wall muscle, ribs, mediastinal organs or tissues
T4 Tumour extends to any of the following: contralateral pleura or lung by direct extension, peritoneum or intra-abdominal organs by direct extension, cervical tissues
N (Lymph Nodes)
NX Regional lymph nodes cannot be assessed
NO No regional lymph nodes metastases
N1 Metastases in ipsilateral bronchopulmonary of hilar lymph nodes
N2 Metastases in ipsilateral mediastinal lymph nodes
N3 Metastases in contralateral mediastinal internal mammary, supraclavicular, or scalene lymph nodes
M (Metastases)
MX Presence of distant metastases cannot be assessed
M0 No known distant metastases
M1 Distant metastasis present

5.2 Staging Diagram