A new study published in the November 2012 issue of the Journal of Thoracic Oncology indicates that it may be time to make revisions to the staging system that has long been widely used to measure the extent of a patient’s malignant pleural mesothelioma.
According to a press release by The International Association for the Study of Lung Cancer (IASLC), the old staging system – known as the International Mesothelioma Interest Group, or IMIG, system – has caused concern among many top professionals in the field of mesothelioma cancer research and treatment. Hence, the IASLC has decided to work towards updating the staging system for malignant pleural mesothelioma by developing a large international database.
The results of a recent study indicate that the current IMIG system does have some strengths, but certain areas of the staging system do indeed need revising. Specifically, the study took a look at more than 3,100 patients from 15 centers on four different continents and determined 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.”
Additionally, the data demonstrated a difference in survival time 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,” the study reports.
The authors of the study, led by Dr. Valerie Rusch of Memorial Sloan-Kettering Cancer Center, also concluded that the staging groups, particular Stage 1 and 2, need to be reassessed and that "the addition of a larger group of patients with more advanced disease, staged clinically and managed non-surgically, may help determine whether Stages 3 and 4 should be classified into a and b subcategories."
It’s often difficult to determine the stage of mesothelioma at diagnosis as it can be quite a complicated form of cancer. In addition, the disease is rarely diagnosed in Stage 1 or 2 but more often in Stage 3 or 4, providing doctors with few looks at patients who are suffering from early stage mesothelioma.
Other study offers include Dorothy Giroux (USA), Catherine Kennedy (Australia), Dr. Erico Ruffini (Italy), Dr. David Rice (USA), Dr. Harvey Pass (USA), Dr. Hisao Asamura (Japan), Dr. John Edwards (U.K.) and Dr. Walter Weder (Switzerland).