Butchart Staging System for Malignant Pleural Mesotheliom

MESOTHELIOMA STAGES


Butchart Staging System for Malignant Pleural Mesothelioma






Butchart Staging System for Malignant Pleural Mesotheliom


MESOTHELIOM STAGES
Butchart Staging System for Malignant Pleural Mesothelioma  &
TNM Staging System for Malignant Pleural Mesothelioma
Below are the 2 most common Mesothelioma staging systems are the Butchart system  commonly referred to as: (Stage 1 mesothelioma, Stage 2 mesothelioma, Stage 3 mesothelioma, Stage 4 mesothelioma) and the tumor, node, metastases TNM Staging System ,T1a,T1b,T2, T3, T4, stages Table 2 introduced by the International Mesothelioma Interest Group. Staging is the process of finding out how far the cancer has spread. Staging of mesothelioma is based on imaging studies such as x-rays, CT scans, and MRI scans.
The treatment and outlook for patients with mesothelioma largely depends on the stage (extent of spread) of their cancer. Since pleural mesothelioma occurs most frequently and has been studied the most, it is the only mesothelioma for which a staging classification exists. The staging system most often used for mesothelioma is the Butchart system. This system is based mainly on the extent of the primary tumor mass, and divides mesotheliomas into stages I through IV. Patients in Stage I of the Disease have a significantly better prognosis than those with more advanced stage. However, due to the relative rarity of this mesothelioma, exact survival information based upon a stage is limited. Once malignant mesothelioma is found, more medical tests are usually performed to find out if cancer cells have spread to other parts of the body. This mesothelioma staging process is essential so that the doctors know the correct stage of the mesothelioma cancer in order to treat it effectively. A staging system based upon thoracic surgery principals and clinical data is shown below:
Table 1. Butchart Staging System for Malignant Pleural Mesothelioma
Stage
Location
I
Tumor confined to the ipsilateral pleura, lung, or pericardium
II
Tumor invading the chest wall or mediastinal structures or metastases to thoracic lymph nodes
III
Tumor penetrating the diaphragm to involve the peritoneum or metastases to extrathoracic lymph nodes
IV
Distant blood-borne metastases
Table 2. TNM Staging System for Malignant Pleural Mesotheliom
Stage
Location
T1a
Limited to ipsilateral parietal pleura (including mediastinal and diaphragmatic pleura), with no involvement of visceral pleura
T1b
Ipsilateral parietal pleura (including mediastinal and diaphragmatic pleura), with scattered foci of visceral pleural involvement
T2
Ipsilateral pleural surface has at least 1 of the following: Diaphragmatic muscle involvement
Confluent visceral pleural tumor involvement (including fissures)
Extension from visceral pleura into pulmonary parenchyma
T3
Locally advanced but resectable tumor; each ipsilateral pleural surface has at least 1 of the following: Involvement of the endothoracic fascia
Extension into the mediastinal fat
Solitary, completely resectable tumor focus in chest wall soft tissues
Nontransmural involvement of the pericardium
T4
Locally advanced, technically unresectable tumor; each ipsilateral pleural surface has at least 1 of the following: Diffuse extension or multifocal chest wall masses with or without rib destruction
Direct transdiaphragmatic extension into the peritoneum
Direct extension to contralateral pleura
Direct extension to 1 or more mediastinal organs
Direct extension into spine
Extension through to internal surface of pericardium, with or without pericardial effusion or myocardial involvement
NX
Regional lymph nodes not assessable
N0
No regional lymph nodes metastases
N1
Metastases in ipsilateral bronchopulmonary or hilar lymph nodes
N2
Metastases in subcarinal or ipsilateral mediastinal lymph nodes, including ipsilateral internal mammary nodes
N3
Metastases in contralateral mediastinal, contralateral internal mammary, and ipsilateral or contralateral supraclavicular lymph nodes
MX
Distant metastases not assessable
M0
No distant metastases
M1
Distant metastases present

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