In collaboration with the International Mesothelioma Interest Group (IMIG),
the International Association for the Study of Lung Cancer (IASLC) decided
to update the
staging system for malignant pleural mesothelioma (MPM) by developing a large
It is widely known that an accurate staging system is essential for assessing
the benefit of new MPM therapies. However until the mid-1990s, no such
evidence-based staging systems existed and few utilized the TNM (tumor,
node, metastasis) system which was developed to achieve consensus on one
globally recognized standard for classifying the extent of the cancer
spread by using the size and extension of the primary tumor, its lymphatic
involvement and the presence of metastases to classify the progression
of cancer. Eventually these revisions, including adopting the TNM system,
were incorporated and accepted by the UICC (International Union Against
Cancer) and the AJCC (American Joint Commission on Cancer) as the international
MPM staging system.
This article succinctly reviews information from analyses of the IASLC
database which is currently the largest multicenter and international
database in MPM and identifies areas in which the current staging system
should be revised.
As IASLC and IMIG investigators continue to expand their database, they
expect the data gathered will more accurately reflect the clinicopathological
and treatment-related prognostic factors which significantly influence
overall survival based on the TNM staging system, tumor histology, gender,
age and type of operation.