From: Malignant Mesothelioma Treatment (PDQ®)
PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Table 3. Definitions of TNM Stages IIIA and IIIBa
| Stage | TNM | Description |
|---|---|---|
| IIIA | T3, N1, M0 | 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: | ||
| –involvement of the endothoracic fascia. | ||
| –extension into the mediastinal fat. | ||
| –solitary, completely resectable focus of tumor extending into the soft tissues of the chest wall. | ||
| –nontransmural involvement of the pericardium. | ||
| N1 = Metastases in the ipsilateral bronchopulmonary, hilar, or mediastinal (including the internal mammary, peridiaphragmatic, pericardial fat pad, or intercostal) lymph nodes. | ||
| M0 = No distant metastasis. | ||
| IIIB | T1–3, N2, M0 | T1 = Tumor limited to the ipsilateral parietal pleura with or without involvement of: |
| –visceral pleura. | ||
| –mediastinal pleura. | ||
| –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: | ||
| –involvement of the endothoracic fascia. | ||
| –extension into the mediastinal fat. | ||
| –solitary, completely resectable focus of tumor extending into the soft tissues of the chest wall. | ||
| –nontransmural involvement of the pericardium. | ||
| N2 = Metastases in the contralateral mediastinal, ipsilateral, or contralateral supraclavicular lymph nodes. | ||
| M0 = No distant metastasis. | ||
| T4, Any N, M0 | 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: | |
| –diffuse extension or multifocal masses of the tumor in the chest wall, with or without associated rib destruction. | ||
| –direct transdiaphragmatic extension of the tumor to the peritoneum. | ||
| –direct extension of the tumor to the contralateral pleura. | ||
| –direct extension of the tumor to the mediastinal organs. | ||
| –direct extension of the tumor into the spine. | ||
| –tumor extending through to the internal surface of the pericardium with or without a pericardial effusion; or tumor involving the myocardium. | ||
| NX = Regional lymph nodes cannot be assessed. | ||
| N0 = No regional lymph node metastases. | ||
| N1 = Metastases in the ipsilateral bronchopulmonary, hilar, or mediastinal (including the internal mammary, peridiaphragmatic, pericardial fat pad, or intercostal) lymph nodes. | ||
| N2 = Metastases in the contralateral mediastinal, ipsilateral, or contralateral supraclavicular lymph nodes. | ||
| M0 = No distant metastasis. |
T = primary tumor; N = regional lymph node; M = metastasis.
aReprinted with permission from AJCC: Malignant Pleural Mesothelioma. In: Amin MB, Edge SB, Greene FL, et al., eds.: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer, 2017, pp 457–68.