The Various Staging Systems for Mesothelioma

Your treatment options are determined based on how advanced your mesothelioma is, or in other words, the stage of mesothelioma you have.

There are three staging systems used for pleural mesothelioma, the Butchart system, the TNM system and the Brigham system.

There is no established staging system for peritoneal mesothelioma.

The Butchart staging system

The Butchart staging system is based on the size and spread of the primary pleural cancer and is divided into four stages.

Stage 1:

Mesothelioma is in the pleura on the right or left side only. It may have grown into the covering of the heart (pericardium) and the diaphragm.

Stage 2:

Mesothelioma has grown into the chest wall. It may be in the pleura on both sides. It may also have grown into the esophagus, heart, or lymph nodes in the chest.

Stage 3:

Mesothelioma has penetrated to the abdominal cavity. It may be found in lymph nodes beyond the chest.

Stage 4:

Mesothelioma has spread through the bloodstream to other organs.

The TNM system

The TNM system is the most common staging system used for mesothelioma patients. The acronym stands for (T) tumor, (N) lymph nodes, and (M) metastasis

Stage 1:

Mesothelioma affects the right or left pleura and may have grown into the covering of the heart (pericardium) and the diaphragm.

Stage 2:

Mesothelioma has spread to both layers of the pleura on the same side of the body.

Stage 3:

Mesothelioma has spread to the chest wall, esophagus or lymph nodes on the same side of the chest.

Stage 4:

Mesothelioma has spread through the bloodstream to other organs in the body such as the liver, brain or bone or to lymph nodes on the other side of the chest.

The Brigham staging system

The Brigham staging system is based on whether the mesothelioma can be removed by surgery and whether the lymph nodes are involved. The four stages in this system are similar to the TNM system.

Stage 1:

Mesothelioma can be removed with surgery and there are no lymph nodes containing cancer cells.

Stage 2:

Mesothelioma can be removed with surgery but there are lymph nodes containing cancer cells.

Stage 3:

Mesothelioma cannot be removed with surgery because it has spread into the chest wall, heart, or through the diaphragm into the peritoneum. There may or may not be lymph nodes containing cancer cells.

Stage 4:

Mesothelioma has spread through the bloodstream to other organs in the body such as the liver, brain or bone.