Eighth edition AJCC/UICC staging for malignant pleural mesothelioma
| Stage | Definition |
| Primary tumour (T) | |
| TX | Primary tumour cannot be assessed |
| T0 | No evidence of primary tumour |
| T1 | Tumour limited to the ipsilateral parietal±visceral± mediastinal±diaphragmatic pleura |
| T2 | Tumour involving each of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic and visceral pleura) with at least one of the following features: ▸Involvement of diaphragmatic muscle ▸Extension if tumour from visceral pleura into the underlying pulmonary parenchyma |
| T3 | Describes locally advanced but potentially resectable tumour. Tumour involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic and visceral pleura) with at least one of the following features: ▸Involvement of endothoracic fascia ▸Extension into the mediastinal fat ▸Solitary, completely resectable focus of tumour extending into the soft tissues of the chest wall ▸Non-transmural involvement of the pericardium |
| T4 | Describes locally advanced technically unresectable tumour. Tumour involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic and visceral pleura) with at least one of the following features: ▸Diffuse extension or multifocal masses of tumour in the chest wall, with or without associated rib destruction ▸Direct transdiaphragmatic extension of tumour to peritoneum ▸Direct extension of tumour to the contralateral pleura ▸Direct extension of tumour to mediastinal organs ▸Direct extension of tumour into the spine ▸Tumour extending through to the internal surface of the pericardium with or without pericardial effusion, or tumour involving the myocardium |
| Regional lymph nodes (N) | |
| NX | Regional lymph nodes cannot be assessed |
| N0 | No regional lymph node metastases |
| N1 | Metastases in the ipsilateral bronchopulmonary, hilar or mediastinal (including the internal mammary, peridiaphragmatic, pericardial fat pad or intercostal lymph nodes) lymph nodes |
| N2 | Metastases in the contralateral mediastinal, ipsilateral or contralateral supraclavicular lymph nodes |
| Distant metastasis (M) | |
| M0 | No distant metastasis |
| M1 | Distant metastasis present |
Reprinted from Journal of Thoracic Oncology, Vol 11, No 12, Rusch V.W et al, THE IASLC Mesothelioma Staging Project: Proposals for the M Descriptos and for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Mesothelioma. 2112-2119 (2016), with permission from Elsevier.