According to the Mesothelioma Guide, there are three main systems of staging pleural mesothelioma. Each system is slightly different but they share commonalities. The Butchart system is the most widely used system and also the oldest; it focuses on the location of the primary tumor. The TNM system is also used for staging other cancers and looks at the tumor, whether the lymph nodes are involved and if it has spread to other parts of the body. Finally, the Brigham system shares similarities with the TNM system but also evaluates how successful surgery would be at each stage.
The cancer is confined to one side of the body usually in the chest wall, lining between the lungs and chest wall, or the lining of the diaphragm, with no lymph node involvement or metastasis. Surgery such as an extrapleural pneumonectomy or pleurectomy and curative treatments are an option for most and the patients with stage 1 mesothelioma have the best prognosis.