Staging of mesothelioma

Raja M. Flores, Valerie W. Rusch

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


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.

Original languageEnglish
Title of host publicationMalignant Mesothelioma
Subtitle of host publicationAdvances in Pathogenesis, Diagnosis, and Translational Therapies
PublisherSpringer New York
Number of pages14
ISBN (Print)0387229493, 9780387229492
StatePublished - 2005
Externally publishedYes


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