Recent Advances in Mesothelioma Staging

Lack of a consensus staging system for malignant pleural mesothelioma has had a profound impact on clinical practice and research, which necessarily relies on comparison of outcomes across multiple institutions and studies for reliable prognostic information. Some lack of agreement arises from the difficulty of conforming this particular cancer to existing staging systems because of its unique biology. The heterogeneous prognosis of patients with differing tumor histology and constant search for new more effective therapies also play a role. Periodic data-driven refinement of staging criteria, based on careful pathologic analysis of histologically homogeneous cohorts, is mandated to provide clinicians with the optimal ability to stratify patients according to survival and select treatments most appropriate for the patient's individual tumor biology.