Skip to main content
SpringerLink
Log in

Staging of Mesothelioma

  • Chapter
Malignant Mesothelioma

  • 944 Accesses

Summary

Accurate staging of MPM allows us to stratify patients for treatment based on survival and to spare patients with advanced disease the morbidity of nonbeneficial surgical treatment. In MPM, patients with tumors of epithelioid histology and T1 or T2N0 stage have the best prognosis. This select group of patients appears to have a favorable survival with multimodality therapy that includes extrapleural pneumonectomy or pleurectomy/decortication and adjuvant radiation with or without chemotherapy. These findings justify the importance of applying staging systems at diagnosis.

Currently CT and PET scanning provide the most accurate invasive staging and are routinely used at our institution; MRI does not appear to add significantly to CT and PET and should be used selectively; and VATS can provide some additional information about T status, transdiaphragmatic tumor invasion, and peritoneal metastases. Although the current AJCC/UICC staging system and the methods available for clinical staging represent advances made in the management of MPM during the past decade, they are imperfect. Further studies to improve the accuracy of staging in MPM are warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Butchart EG, Ashcroft T, Barnsley WC, et al. Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura. Experience with 29 patients. Thorax 1976;31:15–24.

    Article  PubMed  CAS  Google Scholar 

  2. Rusch VW. Indications for pneumonectomy. Extrapleural pneumonectomy. Chest Surg Clin North Am 1999;9:327–338.

    CAS  Google Scholar 

  3. Byrne MJ, Davidson JA, Musk AW, et al. Cisplatin and gemcitabine treatment for malignant mesothelioma: a phase II study. J Clin Oncol 1999;17:25–30.

    PubMed  CAS  Google Scholar 

  4. Vogelzang NJ, Rusthoven J, Symanowski J, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 2003;21:2636–2644.

    Article  PubMed  CAS  Google Scholar 

  5. Mattson K. Natural history and clinical staging of malignant mesothelioma. Eur J Respir Dis 1982;63(suppl 124):87 (abstract).

    Google Scholar 

  6. Chahinian AP, Pajak TF, Holland JF, et al. Diffuse malignant mesothelioma. Prospective evaluation of 69 patients. Ann Intern Med 1982;96:746–755.

    PubMed  CAS  Google Scholar 

  7. Sugarbaker DJ, Strauss GM, Lynch TJ, et al. Node status has prognostic significance in the multimodality therapy of diffuse, malignant mesothelioma. J Clin Oncol 1993;11(6):1172–1178.

    PubMed  CAS  Google Scholar 

  8. Sugarbaker DJ, Flores RM, Jaklitsch MT, et al. Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results of 183 patients. J Thorac Cardiovasc Surg 1999;117:54–65.

    Article  PubMed  CAS  Google Scholar 

  9. Rusch VW. The International Mesothelioma Interest Group: a proposed new international TNM staging system for malignant pleural mesothelioma. Chest 1995;108:1122–1128.

    PubMed  CAS  Google Scholar 

  10. Union Internationale Contre le Cancer. TNM Classification of Malignant Tumours. New York: Wiley-Liss, 2002.

    Google Scholar 

  11. American Joint Committee on Cancer. AJCC Cancer Staging Handbook. New York: Springer-Verlag, 2002.

    Google Scholar 

  12. Boutin C, Rey F. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 1: diagnosis. Cancer 1993;72:389–393.

    Article  PubMed  CAS  Google Scholar 

  13. Tammilehto L. Malignant mesothelioma: prognostic factors in a prospective study of 98 patients. Lung Cancer 1992;8:175–184.

    Article  Google Scholar 

  14. Mountain CF. Revisions in the International System for Staging Lung Cancer. Chest 1997;111:1710–1717.

    PubMed  CAS  Google Scholar 

  15. Allen KB, Faber LP, Warren WH. Malignant pleural mesothelioma. Extrapleural pneumonectomy and pleurectomy. Chest Surg Clin North Am 1994;4:113–126.

    CAS  Google Scholar 

  16. Rusch VW, Venkatraman ES. Important prognostic factors in patients with malignant pleural mesothelioma, managed surgically. Ann Thorac Surg 1999;68:1799–1804.

    Article  PubMed  CAS  Google Scholar 

  17. Ruffie P, Feld R, Minkin S, et al. Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients. J Clin Oncol 1989;7:1157–1168.

    PubMed  CAS  Google Scholar 

  18. Heelan RT, Rusch VW, Begg CB, et al. Staging of malignant pleural mesothelioma: comparison of CT and MR imaging. Am J Radiol 1999;172:1039–1047.

    CAS  Google Scholar 

  19. Rusch VW, Rosenzweig K, Venkatraman E, et al. A phase II trial of surgical resection and adjuvant high dose hemithoracic radiation for malignant pleural mesothelioma. J Thorac Cardiovasc Surg 2001;122:788–795.

    Article  PubMed  CAS  Google Scholar 

  20. Pass HI, Temeck BK, Kranda K, et al. Preoperative tumor volume is associated with outcome in malignant pleural mesothelioma. J Thorac Cardiovasc Surg 1998;115:310–318.

    Article  PubMed  CAS  Google Scholar 

  21. Patz EF Jr, Shaffer K, Piwnica-Worms DR, et al. Malignant pleural mesothelioma: value of CT and MR imaging in predicting resectability. AJR 1992;159:961–966.

    PubMed  Google Scholar 

  22. Knuuttila A, Halme M, Kivisaari L, et al. The clinical importance of magnetic resonance imaging versus computed tomography in malignant pleural mesothelioma. Lung Cancer 1998;22:215–225.

    Article  PubMed  CAS  Google Scholar 

  23. Flores R, Akhurst T, Gonen M, Larson S, Rusch V. Positron emission tomography (PET) defines metastatic disease but not locoregional disease in patients with malignant pleural mesothelioma. J Thorac Cardiovasc Surg 2003;126:11–16.

    Article  PubMed  Google Scholar 

  24. Flores RM, Akhurst T, Gonen M, Larson S, Rusch VW. FDG-PET predicts survival in patients with malignant pleural mesothelioma. Proc Am Soc Clin Oncol 2003;22:620(abstr 2495).

    Google Scholar 

  25. Boutin C, Rey F, Gouvernet J, et al. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 2: prognosis and staging. Cancer 1993;72:394–404.

    Article  PubMed  CAS  Google Scholar 

  26. Conlon KC, Rusch VW, Gillern S. Laparoscopy: an important tool in the staging of malignant pleural mesothelioma. Ann Surg Oncol 1996;3:489–494.

    Article  PubMed  CAS  Google Scholar 

  27. Schouwink JH, Kool LS, Rutgers EJ, et al. The value of chest computer tomography and cervical mediastinoscopy in the preoperative assessment of patients with malignant pleural mesothelioma. Ann Thorac Surg 2003;75:1715–1719.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Raja M. Flores MD

  2. Department of Thoracic Surgery, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Valerie W. Rusch MD

Authors
  1. Raja M. Flores MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valerie W. Rusch MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Thoracic Oncology, Barbara Ann Karmanos Cancer Institute, Harper University Hospital, USA

    Harvey I. Pass MD (Chief and Professor of Surgery and Oncology) (Chief and Professor of Surgery and Oncology)

  2. Wayne State University School of Medicine, Detroit, MI, 48201, USA

    Harvey I. Pass MD (Chief and Professor of Surgery and Oncology) (Chief and Professor of Surgery and Oncology)

  3. Nevada Cancer Institute, USA

    Nicholas J. Vogelzang MD (Director and Clinical Professor) (Director and Clinical Professor)

  4. Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, NV, 81935, USA

    Nicholas J. Vogelzang MD (Director and Clinical Professor) (Director and Clinical Professor)

  5. Thoracic Oncology, Cardinal Bernardin Cancer Center, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, 60153, USA

    Michele Carbone MD, PhD (Professor of Pathology, Director) (Professor of Pathology, Director)

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Springer Science+Business Media, Inc.

About this chapter

Cite this chapter

Flores, R.M., Rusch, V.W. (2005). Staging of Mesothelioma. In: Pass, H.I., Vogelzang, N.J., Carbone, M. (eds) Malignant Mesothelioma. Springer, New York, NY. https://doi.org/10.1007/0-387-28274-2_26

Download citation

  • DOI: https://doi.org/10.1007/0-387-28274-2_26

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-22949-2

  • Online ISBN: 978-0-387-28274-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation