TNM classification for malignant pleural mesothelioma
Tumor classification
Tx: Primary tumor cannot be assessed
T0: No evidence of primary tumor
T1: Tumor involving the ipsilateral parietal pleura with or without involvement of visceral pleura
T2: Tumor involving each of the ipsilateral pleural surfaces with ≥ 1 of the following: confluent visceral pleural tumor; involvement of diaphragmatic muscle; invasion of the lung parenchyma
T3: Tumor involving all of the ipsilateral pleural surfaces with ≥ 1 of the following: invasion of the endothoracic fascia; extension into the mediastinal fat or solitary; completely resectable focus invading soft tissues of the chest wall; non-transmural involvement of the pericardium
T4: Tumor involving all of the ipsilateral pleural surfaces with ≥ 1 of the following: diffuse or multifocal invasion of soft tissues of the chest wall; any rib involvement; invasion of the peritoneum through the diaphragm; invasion of any mediastinal organ; direct extension to the contralateral pleura; invasion of the spine or brachial plexus; transmural invasion of the pericardium or myocardium invasion
Lymph node classification
Nx: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastasis
N1: Metastases in the regional lymph nodes on the same side as the primary tumor, excluding lymph nodes above the clavicle
N2: Metastases in the regional lymph nodes on the opposite side from the primary tumor or to the lymph nodes above the clavicle on either side of the body
Metastasis classification
M0: No distant metastasis
M1: Distant metastasis present
Stage cannot be fully assessed
Reference
Lawek Berzenji, Paul E Van Schil, Laurens Carp. The eighth TNM classification for malignant pleural mesothelioma. Transl Lung Cancer Res. 2018 Oct;7(5):543-549.
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