The Stages of Malignant Mesothelioma
Many cancer registries, such as the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER) use summary staging, a system used for all types of cancer. Summary staging groups cancer into five main categories:
In situ – cancer that is present only in the layer of cells in which it began.
Localized – cancer that is limited to the organ in which it began with no evidence of spread, including:
Invasive tumor (mesothelioma) confined to pleura
Ipsilateral parietal and/or visceral pleura
Mesothelioma WITH nodule(s) beneath visceral pleural surface
Regional – cancer that has spread from the primary site to nearby lymph nodes or organs, which includes:
Regional by direct extension only
Extension to adjacent organs/structure:
No Lung involvement
Mediastinal organs or tissues
Mesothelioma nodule(s) which have broken through the visceral pleural surface to lung surface
REGIONAL Lymph Nodes
Aortic [above diaphragm]
Ascending aorta (phrenic)
Subaortic (aortico-pulmonary window)
Carinal (tracheobronchial) (tracheal bifurcation)
Hilar (bronchopulmonary) (proximal lobar) (pulmonary root)
Azygos (lower peritracheal)
Pre- and retrotracheal
Regional lymph node(s)
Distant – cancer that has spread from the primary site to distant lymph nodes or organs.
Distant lymph node(s):
Contralateral/bilateral hilar (bronchopulmonary) (proximal lobar) (pulmonary root)
Scalene (inferior deep cervical), ipsilateral or contralateral
Supraclavicular (transverse cervical), ipsilateral or contralateral
Other distant lymph node(s)
Cervical (neck) tissues
Mesothelioma WITH malignant pleural fluid
Further contiguous extension
Unknown – cases where not enough information exists to indicate stage.
Note 1: Code 0 is not applicable for this scheme.
Note 2: Ignore pleural effusion which is negative for tumor.