Staging Systems and Current Guidelines in Malignant Pleural Mesothelioma
Pp. 387-398 (12)
The earliest documented staging system for malignant pleural
mesothelioma was proposed by Dr. Eric Butchart in 1976, who defined four stages
of disease using clinical and pathological data from 29 patients who underwent
extrapleural pneumonectomy. In the 1990s, Dr. David Sugarbaker from Brigham and
Women’s Hospital proposed a new ‘functional’ staging system that aimed to predict
resectability and extended survival, with particular attention given to nodal
involvement. Not long after, a separate staging system was proposed by the
International Mesothelioma Interest Group, led by Dr.Valerie Rusch from the
Memorial Sloan-Kettering Cancer Center. For the first time, a collaborative effort
was made to define T and N descriptors according to anatomic definitions consistent
with the traditional TNM staging system. More recently, the International
Association for the Study of Lung Cancer Staging Committee developed an
international database to revise the TNM staging system. The implications of staging
criteria on clinical research are discussed, and a brief summary of existing
international Guidelines is presented.
Extrapleural pneumonectomy, guidelines, pleurectomy/decortication,
staging, systematic review.
The Collaborative Research Group (CORE), Macquaire University, NSW 2050, Sydney, Australia.