Stadium | Forklaring |
---|---|
T1 | Tumor limited to the ipsilateral parietal ± visceral ± mediastinal ± diaphragmatic pleura |
T2 | Tumor involving each of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features: •involvement of diaphragmatic muscle •extension of tumor from visceral pleura into the underlying pulmonary parenchyma |
T3 | Describes locally advanced but potentially resectable tumor. Tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features:
|
T4 | Describes locally advanced technically unresectable tumor. Tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following features:
|
N1 | Metastases in the ipsilateral bronchopulmonary, hilar, or mediastinal (including the internal mammary, peridiaphragmatic, pericardial fat pad, or intercostal lymph nodes) lymph nodes |
N2 | Metastases in the contralateral mediastinal, ipsilateral, or contralateral supraclavicular lymph nodes |
M1 | Distant metastasis present |
Stadium | N0 | N1 | N2 |
---|---|---|---|
T1 | IA | II | IIIB |
T2 | IB | II | IIIB |
T3 | IB | IIIA | IIIB |
T4 | IIIB | IIIB | IIIB |
M1 | IV | IV | IV |
Anbefaling - Utredning av mesoteliom:
- Malignt pleuralt mesoteliom mistenkes ved pleuraeffusjon, pleural fortykkelse og samtidig brystsmerter.
- CT toraks med kontrast er basis for diagnostikk og staging.
- For videre cyto-/histologisk diagnostikk gjøres aspirering for cytologi, og pleural biopsering (helst torakoskopisk).
- Histologisk bekreftelse av diagnosen må etterstrebes. Siden negativ cytologi/pleural biopsi ikke utelukker mesoteliom bør videre utredning gjøres.
- Ved vurdering for kurativ behandling skal PET/CT utføres. I en ikke-kurativ situasjon er det ikke indikasjon for PET/CT, med mindre dette er ønskelig før biopsi, for mer sannsynlig å få representativ prøve.