Brigham Staging System
Currently, the most effective form of mesothelioma treatment is multimodal and involves the combined use of several different treatment therapies including surgery, chemotherapy and radiotherapy. The Brigham Staging System defines whether or not surgery is a viable treatment option for a mesothelioma patient and whether or not there is lymph node involvement. It is similar to both the Butchart staging system and the TNM Staging System however in that it too defines the progression of mesothelioma in four stages. These stages are described below.
- Stage 1: Mesothelioma is localized in the pleura, lung, pericardium, diaphragm, or chest wall, lymph nodes show no sign of cancer and surgery is an option.
- Stage 2: Mesothelioma is confined to specific areas as defined in Stage 1 but cancer has spread to lymph nodes. Surgery is still a viable treatment option in this stage.
- Stage 3: Mesothelioma is no longer confined as in Stage 1 and 2. It has spread into the chest wall, heart, or through the diaphragm into the peritoneum. Surgery is no longer an option. Cancer may or may not be in the lymph nodes in this stage.
- Stage 4: Mesothelioma has spread to other organs and tissues through the bloodstream. Metastatic disease is pervasive in the body.
The Brigham Staging System can help doctors identify how far the disease has progressed, what treatment or combination of treatment therapies can be used and what the mesothelioma patient’s prognosis is.
Vanderbilt University Medical Center – Department of Thoracic Surgery
David J. Sugarbaker and JoseJ. Norberto. “Multimodality Management of Malignant Pleural Mesothelioma.” Chest 1998