label: Stage IV Pleural Malignant Mesothelioma AJCC v7
label_lc: stage iv pleural malignant mesothelioma ajcc v7
description: "Stage IV includes: (T4, Any N, M0); (Any T, N3, M0); (Any T, Any N, M1).  T4: Pleural mesothelioma with a locally advanced technically unresectable tumor.  Tumor involving all the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least one of the following: diffuse extension or multifocal masses of tumor in the chest wall, with or without associated rib destruction; direct transdiaphragmatic extension of tumor to the peritoneum; direct extension of tumor to the contralateral pleura; direct extension of tumor to mediastinal organs; direct extension of 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.  N3: Pleural mesothelioma with metastases in the contralateral mediastinal, contralateral internal mammary, ipsilateral or contralateral supraclavicular lymph nodes.  M0: No distant metastasis.  M1: Distant metastasis. (AJCC 7th ed.)"