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Analysis of the Updated IASLC Staging Database for Mesothelioma Patients

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 international database.

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.