Mesothelioma Stadium

Stadium is the term used to describe the level of cancer patients, based on primary tumor and spread in the body. This can help the medical team treatment plan, prognosis estimation and identification of clinical trials for patients who may be eligible.

Stadium is based on knowledge of how cancer develops, the primary tumor, invasion of nearby organs and tissues, to spread or distant metastases. Stadium System has evolved from time to time, and they keep changing as scientists learn more about cancer. Some staging systems cover many types of cancer, while others focus on more specific cancer. The TNM (primary tumor, regional lymph nodes, distant metastases) is the most common system for staging mesothelioma.

Some common elements to most of the staging system:

* Location of primary tumor.
* Size and number of 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 that is used for all types of cancer. Summary staging cancer groups into five main categories:

* In situ - cancer that was present only in the layer of cells where it begins.
* Localized - cancer confined to the organ in the beginning with no evidence of spread.
* Areas - cancer that has spread from primary site to nearby lymph nodes or organs.
* Far - cancer that has spread from the main site to the lymph nodes or distant organs.
* Unknown - cases where there is not enough information to indicate the stage.

Several types of tests can be used to help doctors determine the stage, and formulate a treatment plan.

* Physical examination. The doctor examined the body with the look, feel and listen to something extraordinary.
* Imaging techniques. Procedures such as x-rays, CT scans, MRI and PET scans can show the location, tumor size and whether the cancer has spread.
* Laboratory tests. Studies of blood, urine, fluids and tissues can provide information about cancer. tumor marker, sometimes increased when cancer is present, can provide information.
* Pathology reports. Tissue sample examination results can include information about the size of the tumor (s), extension into adjacent structures, the type and grade of tumor cells. Examination of cells in the fluid, such as those from mesothelioma-related pleural effusion, can also provide information.
* Surgical report. Observations on the size and appearance of the tumor (s), lymph nodes and nearby organs.

Stadium information should be given to patients with a doctor so that a potential treatment plan can be discussed. Mesothelioma stages, as well as consideration of other factors such as age, health status and patient preference may determine the different treatment options.

Staging system is the oldest and most frequently used is the Butchart system, based primarily on the level of the primary tumor mass and divides mesotheliomas into four stages. More recent TNM system considers variables tumor mass and spread, lymph node involvement, and metastasis. Brigham System is the latest system and stages mesothelioma according to resectability (the ability to eliminate operating) and lymph node involvement.

Butchart System - the level of the primary tumor mass

* Stage I: Mesothelioma present in the right or left pleura and may also involve the diaphragm on the same side.
* Stage II: Mesothelioma attacks the chest wall or involves the esophagus, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
* Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may also be involved.
* Stage IV: There is evidence of metastasis or spread through the bloodstream to other organs.

TNM System - variables T (tumor), N (lymph nodes), M (metastasis)

* Stage I: Mesothelioma involves right or left pleura and may also spread to the lung, pericardium, or diaphragm on the same side. Lymph nodes are not involved.
* Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It also may have spread to the lung, pericardium, or diaphragm on the same side.
* Stage III: Mesothelioma is now in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side with or without spread to lymph nodes on the same side with the primary tumor.
* Stage IV: Mesothelioma has spread to the lymph nodes in the chest on the side opposite the primary tumor, or extends to the pleura or lung on the opposite side, or directly extends into organs in the abdominal cavity or neck. Any distant metastases is included in this phase.

Brigham System: (variables tumor resectability and nodal status)

* Phase I: resectable mesothelioma and no lymph node involvement
* Phase II: resectable mesothelioma but with lymph node involvement
* Stage III: Unresectable mesothelioma extending into chest wall, heart, or through diaphragm, peritoneum, with or without extrathoracic lymph node involvement
* Stage IV: Distant metastatic disease