Study shows revisions in MPM staging system might be needed in future

The International Mesothelioma Interest Group (IMIG) staging system has been widely used, however, widespread concerns exist about the validity of the current malignant pleural mesothelioma (MPM) staging system. Concerns include that the system is derived from analysis of small, retrospective surgical series; it can be difficult to apply to clinical staging; and uses descriptors for lymph node involvement, which may not be relevant to MPM. Therefore, in collaboration with IMIG, the International Association for the Study of Lung Cancer (IASLC) has decided to update the staging system for MPM by developing a large international database.

A study, published in the November 2012 issue of the IASLC'S , reports the current by and large appropriately distinguishes among T and N categories and overall stages but also highlights areas for potential revision.

The study looked at 3,101 patients from 15 centers in four continents. The current data still represents mainly surgically treated patients. The authors report that current T descriptors are qualitative and most applicable to pathological staging. Possibly in the future, volumetric tumor measurement could enhance the current T descriptors.

In addition, the data demonstrate a difference in survival for node-negative versus node-positive patients. The difference between N1 and N2 disease is less clear, suggesting that additional study of the extent of lymph node involvement might yield improvements in the N-classification factor.

And finally the authors suggest that staging groups, especially for stages I and II disease, need to be reassessed. In the future, they say, "the addition of a larger group of patients with more advanced disease, staged clinically and managed nonsurgically may help determine whether stages III and IV should be classified into a and b subcategories."

Related Stories

New lung cancer staging system revealed

date Jul 13, 2009

For the first time in more than 10 years, the universally accepted lung cancer staging system has been revised to more accurately reflect the prognosis for patients with non-small cell lung cancer (NSCLC).

The gold standard in cancer staging now as Web tool

date Oct 05, 2010

Springer is launching the AJCC e-Staging Tool, a web-based application which will improve the way cancer is staged. Designed to meet the needs of the entire multidisciplinary team in any facility that deals with cancer, ...

Recommended for you

Experts set strategic priorities for lymphoma research

date 17 hours ago

A committee of lymphoma experts today unveiled a strategic roadmap identifying key priority areas in both infrastructure and research that will be critical for advancing treatments for people with lymphoma. The report is meant to inform future research directions as well as fund ...

Research aims to reduce health care disparities

date 17 hours ago

The lesbian, gay, bisexual, transgender/transsexual, queer/questioning and intersex (LGBTQI) population has been largely understudied by the medical community. Researchers at Moffitt Cancer Center found that the LGBTQI community ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.