NCCN Guidelines for Patients
Malignant Pleural Mesothelioma, Version 1.2014
The recommended treatment for mesothelioma is
based on two features of the cancer. One of these
features is the clinical stage. The clinical stage
is a rating of the extent of the cancer based on
tests before treatment. The AJCC (
ancer) staging system is most often
used for mesothelioma. In this system, there are four
cancer stages based on the growth and spread of the
cancer. These stages are described in
Chart 4. Stages of mesothelioma
The tumor hasn’t grown beyond the pleura where it started.
The tumor has grown into the diaphragm or the lung or both.
The tumor has grown into 1) the first layer of the chest wall or a confined area of
the other layers, 2) the fat between the lungs, or 3) the pericardium, and/or
The cancer has spread to nearby lymph nodes or the nodes at the base of the
The tumor has grown into 1) a wide area of the chest wall, 2) the peritoneum,
3) an organ between the lungs, 4) the spine, or 5) the pleura around the other lung,
• The cancer has spread to the lymph nodes near the other lung or near the
• The cancer has spread to distant sites.