A malignant mesothelioma of the pleura can be classified and staged using the TNM system of the American Joint Committee on Cancer.
|
T Classification |
T |
|
primary tumor cannot be assessed |
TX |
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no evidence of primary tumor |
T0 |
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tumor limited to the ipsilateral parietal and/or visceral pleura |
T1 |
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tumor invades any of the following: ipsilateral lung, endothoracic fascia, diaphragm, or pericardium |
T2 |
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tumor invades any of the following: ipsilateral chest wall muscle, ribs, or mediastinal organs or tissues |
T3 |
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tumor directly extends to any of the following: contralateral pleura, contralateral lung, peritoneum, intra-abdominal organs, cervical tissues |
T4 |
|
N Classification |
N |
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no metastasis to regional lymph nodes |
N0 |
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metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes (includes intrapulmonary nodes involved by direct extension from the tumor) |
N1 |
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metastasis to ipsilateral mediastinal and/or subcarinal lymph nodes |
N2 |
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metastasis to contralateral mediastinal, contralateral hilar, ipsilateral scalene, contralateral scalene or supraclavicular lymph nodes |
N3 |
|
M Classification |
M |
|
presence of distant metastasis cannot be assessed |
MX |
|
no evidence of distant metastasis |
M0 |
|
distant metastasis present |
M1 |
|
Stage |
TNM |
|
I |
T1 N0 M0 |
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T2 N0 M0 |
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II |
T1 N1 M0 |
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T2 N1 M0 |
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III |
T1 N2 M0 |
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T2 N2 M0 |
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T3 N0 M0, T3 N1 M0, T3 N2 M0 |
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IV |
T1 N3 M0, T2 N3 M0, T3 N3 M0 |
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T4 N0 M0, T4 N1 M0, T4 N2 M0, T4 N3 M0 |
|
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(any T) (any N) M1 |
After preoperative radiation and/or chemotherapy, residual tumor may be described using an "R" designation:
• RX: presence of residual tumor cannot be assessed
• R0: no residual tumor
• R1: microscopic residual tumor
• R2: macroscopic residual tumor
Specialty: Hematology Oncology, Surgery, general, Pulmonology
