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Table 2 TNM classification of MM, according to the 7th AJCC Cancer Staging Manual

From: Imaging characteristics of pleural tumours

T (sum of the extent of spread of the primary tumour)

TXa

The main tumour cannot be assessed for some reason

T0a

No evidence of a main tumour

T1a

MMT involvement of the pleura on one side of the chest (even the diaphragmatic or mediastinal pleura)

T2a

T1 + involvement of chest wall, diaphragmatic and mediastinal pleura and at least one of diaphragm or lung infiltration

T3a

T2 + infiltration of at least one of the following: endothoracic fascia, fatty mediastinal tissue, a SINGLE place in the deeper layers of the chest wall, surface of the pericardium

T4b

T3 + infiltration of at least one of the following: more than one place in the deeper layers of the chest wall, the peritoneum, any organs in the mediastinum, the spine, the other side of the chest, the heart muscle

N (regional lymph nodes involvement)

NX

The nearby lymph nodes cannot be assessed

N0

No spread to the nearby lymph nodes

N1

Spread to the hilar or bronchial lymph nodes on the same side as the primary tumour

N2

Spread to other lymph nodes on the same side as the primary tumour (subcarinal, mediastinal, internal mammary and peridiaphragmatic)

N3

Spread to the supraclavicular lymph nodes and/or to those on the opposite side to the primary tumour

M (primary tumour spread to the other organs of the body)

M0

No spread to distant organs or areas

M1

Spread to distant sites (lymph nodes and organs)

  1. aMMT may still possibly be surgically removed
  2. bMMT has grown too far to be completely surgically removed