How to Stage Pleural Mesothelioma

Mesothelioma is one of diseases that almaost 100% preventable. The only known cause is through exposure of asbestos. Mesothelioma can be staged by three staging systems : Brutchart system, TNM system and Brighan system. Brutchart system is the oldest one to stage mesothelioma by extent of primary tumor mass. TNM system stages mesothelioma by considering of tumor in mass and spread, lymph node involvement, and metastasis. The latest one is Brigham system, stages mesothelioma by resectability and lymph node involvement, whether the mesothelioma can be surgically removed or not and whether the lymph nodes are affected or not.

Burchart System
Stage I: Presence of mesothelioma in the lining of the right lung and may involve the diaphragm on the same side.
Stage II: Mesothelioma spreads to the chest wall or esophagus, heart, or lung lining on both side.
Stage III: Mesothelioma penetrates throguh the diaphragm into the lining of the abdominal cavity or peritoneum.
Stage IV: Mesothelioma spreads to other organ (metastasis).

TNM System
Stage I: Mesothelioma involves the lining of the right or left lung, pericardium, or diaphragm on the same side. Lymph nodes are not involved.
Stage II: Mesothelioma spreads to the lining of the lung on one side and a lumpht node on the same side.
Stage III: Mesothelioma exists in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side as the primary tumor.
Stage IV: Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, or extends into the lung opposite the primary tumor, or directly into organs in abdominal cavity or nex (metastasis).

Brigham System
Stage I: The tumor is resectable (can be surgically removed) and lymph nodes are unaffected.
Stage II: The tumor remains respectable but the mesothelioma affects the lymph node.
Stage III: The tumor is not resectable and extends into the chest wall, heart, or through diaphragma, and pertoneum.
Stage IV: Mesothelioma becomes metastatic into distant organs.