The Stages of Malignant Mesothelioma
The Butchart system is the oldest system, developed by Dr. E.G. Butchart, at the Department of Cardiothoracic Surgery, Shotley Bridge General Hospital and Department of Pathology, University of Newcastle upon Tynewas back in 1978 (http://thorax.bmj.com/content/31/1/15.full.pdf).
The system suggested that an analysis of the mediastinal lymph node involvement along with the size and extent of primary tumor mass could be used to determine mesothelioma cancer stage. This system utilized mediastinoscopy and macroscopical diaphragmatic penetration by radiology of the undersurface of the diaphragm using artificial pneumoperitoneum to diagnose the stage of mesothelioma cancer dependant on lymph node involvement and tumor spread.
In its time, the Butchart System was considered an incredible breakthrough in defining mesothelioma in stages and contributed greatly to the advancement of mesothelioma treatment options. It was simple, thus it gained acceptance as one of the first universal staging systems. However, it failed to address some critical issues. Medical experts suggest it fails to make survival correlations with mesothelioma stages and has limited and inaccurate references to chest wall invasion and lymph node involvement. The Butchart mesothelioma staging system today is obsolete for providing mesothelioma life expectancy statistics, however many cancer institutions modify it and use it for their evaluative purposes, as they believe the Butchart System still has the advantage of simplicity and relevance to prognosis and therapeutic options today.
Below are the four stages that the Butchart System uses to identify mesothelioma stage:
Stage I: Tumour confined to homolateral pleura, lung, and pericardium
Stage II: Tumour invading chest wall or involving mediastinal structures, eg, oesophagus, heart, oppositeMesothelioma invades the chest wall or involves the esophagus, heart, or pleura on bbutchart-staging-systemoth sides. Lymph nodes involvement in the chest..
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. Tumour penetrating diaphragm to involve peritoneum directly Lymph node involvement outside the chest
Stage IV: There is evidence of metastasis or spread through the bloodstream to other organs. Distant blood-borne metastases
